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Marta Szebehely. Foto: Björn Dalin

Marta Szebehely

Professor i socialt arbete med inriktning mot omsorg

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Arbetar vid Institutionen för socialt arbete
Telefon 08-674 73 94
E-post marta.szebehely@socarb.su.se
Besöksadress Sveavägen 160, Sveaplan
Rum 741
Postadress Institutionen för socialt arbete 106 91 Stockholm

Om mig

Marta Szebehely är professor i socialt arbete med inriktning mot äldre vid Stockholms universitet. Hon har forskat om äldreomsorg och andra omsorgsfrågor ur vardags-, genus- och socialpolitiska perspektiv sedan mitten av 1980-talet.

Hon är ansvarig för forskningsprogrammet Individanpassad omsorg och generell välfärd: dilemman i marknadiseringens tid; ett forskningsprogram med finansiering (3 miljoner per år) från Forte 2014-2016 med möjlig förlängning ytterligare tre år. Hon är också ansvarig för Normacare, ett nordiskt forskarnätverk om marknadisering inom äldreomsorgen (finansierat av Forte och NordForsk), samt de svenska grenarna av två komparativa projekt om äldreboenden i olika länder Re-imagining Long-term Care Residential Care och Healthy Ageing in Residential Places- HARP.

Under 2007-2013 var hon ansvarig för ett sexårigt forskningsprogram finansierat av Forte: Omsorg i omvandling: Vardagsliv, organisering och välfärdspolitik. Under samma period var hon också ansvarig för temat 'Care in ageing and diversifying societies' i det nordiska excellenscentret REASSESS (Reassessing the Nordic Welfare Model).

CV Marta Szebehely (pdf) (53 Kb)

Publikationer

I urval från Stockholms universitets publikationsdatabas
  • 2017. Marta Szebehely, Anneli Stranz, Rebecka Strandell.
  • 2017. Evy Gunnarsson, Marta Szebehely.
  • 2017. Evy Gunnarsson, Marta Szebehely. Genus i omsorgens vardag, 13-28
  • 2017. Charlene Harrington (et al.).

    This article presents cross-country comparisons of trends in for-profit nursing home chains in Canada, Norway, Sweden, United Kingdom, and the United States. Using public and private industry reports, the study describes ownership, corporate strategies, costs, and quality of the 5 largest for-profit chains in each country. The findings show that large for-profit nursing home chains are increasingly owned by private equity investors, have had many ownership changes over time, and have complex organizational structures. Large for-profit nursing home chains increasingly dominate the market and their strategies include the separation of property from operations, diversification, the expansion to many locations, and the use of tax havens. Generally, the chains have large revenues with high profit margins with some documented quality problems. The lack of adequate public information about the ownership, costs, and quality of services provided by nursing home chains is problematic in all the countries. The marketization of nursing home care poses new challenges to governments in collecting and reporting information to control costs as well as to ensure quality and public accountability.

  • 2017. Marta Szebehely, Gabrielle Meagher. Journal of European Social Policy

    This paper builds on recent research on the fortunes of universalism in European social policy by tracing the development of eldercare policy in four Nordic countries: Denmark, Finland, Norway and Sweden. Six dimensions of universalism are used to assess whether and how eldercare has been universalised or de-universalised in each country in recent decades and the consequences of the trends thereby identified. We find that de-universalisation has occurred in all four countries, but more so in Finland and Sweden than in Denmark and Norway. Available data show an increase in for-profit provision of publicly funded care services (via policies promoting service marketisation), and an increase of family care (re-familialisation) as well of services, paid out-of-pocket (privatisation). These changes have occurred without an explicit attack on universalism or retrenchment of formal rights but are threatening the class- and gender-equalising potential of Nordic welfare states.

  • 2017. Marta Szebehely. Genus i omsorgens vardag, 29-48
  • 2017. Marta Szebehely.
  • 2017. Marta Szebehely, Anneli Stranz, Rebecka Strandell.
  • 2017. Madeleine Starr, Marta Szebehely.

    Most developed countries have introduced significant changes in housing and longterm care policies for older people. Simultaneously, there is increasing policy and economic emphasis on extending working lives and on changes to pension schemes. These changes have combined to have negative consequences for working-age family carers. In this contribution, Madeleine Starr MBE, Director of Business Development and Innovation at Carers UK, and Marta Szebehely, Professor of Social Work at Stockholm University, Sweden, discuss the situations in the UK and Sweden – two countries with different policy traditions but facing similar challenges.

  • 2016. Gabrielle Meagher, Marta Szebehely, Jane Mears. Work, Employment and Society 30 (5), 731-749

    This article seeks to understand a puzzling finding: that workers in publicly-funded home care for older people in Australia, compared to those in Sweden, feel that they are better able to meet their clients’ needs, that their workplaces are less pressed, and that their work is less burdensome and more compatible with their family and social commitments. This finding seems to challenge expectations fostered by comparative sociological research that job quality and care services are inferior in Australia compared to Sweden. Informed by comparative institutionalist theory and care research, the structures and dynamics of the care systems in the two countries are analyzed, along with findings from the NORDCARE survey of home care workers conducted in Sweden in 2005 (n=166) and Australia in 2010 (n=318). Differences in the work and working conditions in the two countries are explained by the dynamic interaction of national institutional and highly gendered sector-level effects.

  • 2016. Jacqueline A. Choiniere (et al.). Ageing International 41 (1), 40-61

    International quality concerns regarding long-term residential care, home to many of the most vulnerable among us, prompted our examination of the audit and inspection processes in six different countries. Drawing on Donabedian’s (Evaluation & Health Professions, 6(3), 363–375, 1983) categorization of quality criteria into structural, process and outcome indicators, this paper compares how quality is understood and regulated in six countries occupying different categories according to Esping Andersen’s (1990) typology: Canada, England, and the United States (liberal welfare regimes); Germany (conservative welfare regime); Norway, and Sweden (social democratic welfare regimes). In general, our review finds that countries with higher rates of privatization (mostly the liberal welfare regimes) have more standardized, complex and deterrence-based regulatory approaches. We identify that even countries with the lowest rates of for profit ownership and more compliance-based regulatory approaches (Norway and Sweden) are witnessing an increased involvement of for-profit agencies in managing care in this sector. Our analysis suggests there is widespread concern about the incursion of market forces and logic into this sector, and about the persistent failure to regulate structural quality indicators, which in turn have important implications for process and outcome quality indicators.

  • 2016. Marta Szebehely. Journal of Canadian studies 50 (2), 499-507

    Based on a qualitative rapid ethnography study, this article analyzes everyday care work in nursing homes in Ontario and Sweden. The comparison is linked to the broader socio-political and organizational contexts in the two jurisdictions. Policy documents in both locations stress that care services should be of high quality and individually adapted. The organizational preconditions to provide such care were better in the Swedish care homes because of higher staffing ratios, fewer routines, and more time for collegial support. The workers therefore had more opportunities to adapt their efforts to meet residents' different and changing needs. In both jurisdictions, however, the care workers' own needs were often disregarded, and their health and well-being were at risk.

  • 2015. Petra Ulmanen, Marta Szebehely. International Journal of Social Welfare 24 (1), 81-92

    This article analyses the changing roles of the state, family and market in providing care for older people in Sweden, in relation to Scandinavian welfare ideals of universalism and de-familisation. Since 2000 every fourth residential care bed has disappeared and the increase in homecare services has not compensated for the decline. Instead family care (defined here as help from adult children and other non-cohabiting family or friends) has increased in all social groups: help by daughters mainly among older people with shorter education and help by sons among those highly educated. Use of privately purchased services has also increased but continues to play a marginal role. Family care remains more common among older people with less education whereas privately purchased services are more common among those with higher education. This dualisation of care challenges universalism, and working-class daughters continue to be most affected by eldercare cutbacks.

  • 2014. Marta Szebehely, Petra Ulmanen, Ann-Britt Sand.
  • 2014. Marta Szebehely. Alltid någon annan som väntar, 165-178
  • 2014. Marta Szebehely, Gun-Britt Trydegård. Tre decennier med socialtjänstlagen, 103-126
  • Kapitel Introduktion
    2014. Ulla Pettersson (et al.). Tre decennier med Socialtjänstlagen, 11-19
  • 2014. Liz Lloyd (et al.). International journal of sociology and social policy 34 (1/2), 2-18

    Purpose – This study aims to explore the causes and consequences of media scandals involving nursing homes for older persons in Canada, Norway, Sweden, the UK and the USA.

    Design/methodology/approach – This study uses a descriptive case-study methodology which provides an in-depth, focused, qualitative analysis of one selected nursing home scandal in each jurisdiction. Scandals were selected on the basis of being substantive enough to potentially affect policy. An international comparative perspective was adopted to consider whether and how different social, political and economic contexts might shape scandals and their consequences.

    Findings – This study found that for-profit residential care provision as well as international trends in the ownership and financing of nursing homes were factors in the emergence of all media scandals, as was investigative reporting and a lack of consensus around the role of the state in the delivery of residential care. All scandals resulted in government action but such action generally avoided addressing underlying structural conditions.

    Research limitations/implications – This study examines only the short-term effects of five media scandals.

    Originality/value – While there has been longstanding recognition of the importance of scandals to the development of residential care policy, there have been few studies that have systematically examined the causes and consequences of such scandals. This paper contributes to a research agenda that more fully considers the media's role in the development of residential care policy, attending to both its promises and shortcomings.

  • 2014. Marta Szebehely, Petra Ulmanen, Ann-Britt Sand. Dagens samhälle (7 januari)
  • 2014. Marta Szebehely. Alla dessa marknader, 129-141

    Ekonomer tenderar att vara mer positiva än omsorgsforskare till vinstdrivande välfärdsföretag. De förra ser höjd kvalitet och effektivitet, de senare risk för ökad ojämlikhet.

  • 2013. Hildegard Theobald, Marta Szebehely, Maren Preuss.

    Durch die demographische Entwicklung wird der Bedarf an Pflegekräften für die professionelle Versorgung in der Altenhilfe zunehmen das ist ebenso unbezweifelbar wie die Vorhersage, dass es zum Problem werden wird, den Bedarf zu decken. Es könnte ein Beitrag zur Lösung dieses Problems sein, wenn Pflegekräfte ihre Tätigkeit weniger oft unterbrechen oder in andere Positionen wechseln, als das in Deutschland gegenwärtig der Fall ist. Der Vergleich mit Schweden, wo Pflegekräfte viel länger und kontinuierlicher tätig sind, verspricht hier interessante Aufschlüsse. Das Forschungsprojekt, über das in diesem Buch berichtet wird, hat mit jeweils 600 Pflegekräften in der ambulanten und stationären Altenpflege in beiden Ländern untersucht, wovon der Verbleib im Beruf abhängt. Vor dem Hintergrund von Pflegepolitiken, Organisation und Professionalisierung der Pflege wurden Anstellungs- und Arbeitssituation, Berufsverlauf und Vereinbarkeit von Beruf und Familie verglichen. Die Ergebnisse zeigen unter anderem: Die Qualifikation der Beschäftigten spielt eine große Rolle, ebenso die Ausgestaltung und Familienfreundlichkeit der Beschäftigungsverhältnisse sowie die Arbeitsbelastungen und die Ressourcen zu deren Bewältigung.

  • 2013. Hildegard Theobald, Marta Szebehely.
  • 2013. Outi Jolanki, Marta Szebehely, Kaisa Kauppinen. Combining paid work and family care

    The chapter addresses the characteristics and situations of working carers of older people in Finland and Sweden.  It draws together knowledge on employment legislation, public policy and payments to working carers with studies on family care of older people. The central questions addressed are: Who are the carers? What kind of support is available for them? Are their working lives affected by caring responsibilities? And how do they perceive their everyday lives?  The chapter shows that in both countries, family carers, the majority of whom are working women, have a major role in older people’s care. It argues that restructuring older people’s public care services has implicitly increased the expectation that family members will provide care, and notes that, while in the 2000s family care and working carers of older people have risen up the political agenda, legislation and practical actions to support them are still largely absent.

  • 2013. Rosmari Eliasson-Lappalainen, Marta Szebehely. Äldre i centrum (4)
  • 2013. Gabrielle Meagher, Marta Szebehely. Reforms in long-term care policies in Europe, 55-78

    Sweden constitutes a traditionally well-developed system of long-term care, based on tax-funded, mainly publicly provided services. This system has changed significantly in recent decades. There has been some retrenchment in eldercare evident in falling coverage and stronger targeting of people with higher levels of need. This development has led to the informalization of care for some groups of older people. In disability care, there has been a considerable expansion of services, perhaps most notably in the introduction of a personal assistance scheme for people with severe disabilities. These divergent trends in services for older people and people with disabilities have coincided with a convergent development across both care fields: the marketization of services and the emergence of large, corporate, for-profit providers. This chapter explains how and why these changes have happened, and their consequences for service users and for the possible future of social care in Sweden. In addition to the dynamic interaction of state-steering and municipal response that are typically important in explaining change in patterns of social service in countries with multilevel government, “invasive displacement” and “layering” are identified as processes transforming the institutions that directly and indirectly organize care service provision.

  • 2013. Gabrielle Meagher, Marta Szebehely.
  • 2013. Sara Erlandsson (et al.). Marketisation in Nordic eldercare, 23-84
  • 2012. Mia Vabø, Marta Szebehely. Welfare State, Universalism and Diversity, 121-143
  • 2012. Marta Szebehely. Framtider - tidskrift från institutet för Framtidsstudier (1), 17-19
  • 2012. Tine Rostgaard, Marta Szebehely. European Journal of Ageing 9 (2), 101-109

    Despite pursuing the policy of ageing in place, the two Nordic countries of Denmark and Sweden have taken diverse roads in regard to the provision of formal, public tax-financed home care for older people. Whilst Sweden has cut down home care and targeted services for the most needy, Denmark has continued the generous provision of home care. This article focuses on the implication of such diverse policies for the provision and combination of formal and informal care resources for older people. Using data from Level of Living surveys (based on interviews with a total of 1,158 individuals aged 67-87 in need of practical help), the article investigates the consequences of the two policy approaches for older people of different needs and socio-economic backgrounds and evaluates how the development corresponds with ideals of universalism in the Nordic welfare model. Our findings show that in both countries tax-funded home care is used across social groups but targeting of resources at the most needy in Sweden creates other inequalities: Older people with shorter education are left with no one to resort to but the family, whilst those with higher education purchase help from market providers. Not only does this leave some older people more at risk, it also questions the degree of de-familialisation which is otherwise often proclaimed to be a main characteristic of the Nordic welfare model.

  • 2012. Gabrielle Meagher, Marta Szebehely. Changing Social Inequality, 89-118
  • 2012. Marta Szebehely, Gun-Britt Trydegård. Health & Social Care in the Community 20 (3), 300-309

    One aspect of universalism in Swedish eldercare services is that publicly financed and publicly provided services have been both affordable for the poor and attractive enough to be preferred by the middle class. This article identifies two trends in home care for older people in Sweden: a decline in the coverage of publicly funded services and their increasing marketisation. We explore the mechanisms behind these trends by reviewing policy documents and official reports, and discuss the distributional consequences of the changes by analysing two data sets from Statistics Sweden: the Swedish Level of Living surveys from 1988 ⁄ 1989 and 2004 ⁄ 2005 and a database on all users of tax deductions on household and care services in 2009. The analysis shows that the decline of tax-funded home care is not the result of changing eldercare legislation and was not intended by national policy-makers. Rather the decline was caused by a complex interplay of decision-making at central and local levels, resulting in stricter municipal targeting. The trend towards marketisation has been more clearly intended by national policy-makers.

    Legislative changes have opened up tax-funded services to private provision, and a customer-choice (voucher) model and a tax deduction for household- and care services have been introduced. As a result of declining tax-funded home-care services, older persons with lower education increasingly receive family care, while those with higher education are more likely to buy private services. The combination of income-related user fees, customer-choice models and the tax deduction has created an incentive for high-income older persons to turn to the market instead of using public home-care services. Thus, Swedish home care, as a universal welfare service, is now under threat and may become increasingly dominated by groups with less education and lower income which, in turn, could jeopardise the quality of care.

  • 2012. Marta Szebehely. Tidsskrift for velferdsforskning 15 (2), 134-139
  • 2012. Charlene Harrington (et al.). Journal of Nursing Scholarship 44 (1), 88-98

    Purpose: This study was designed to collect and compare nurse staffing standards and staffing levels in six counties: the United States, Canada, England, Germany, Norway, and Sweden. Design: The study used descriptive information on staffing regulations and policies as well as actual staffing levels for registered nurses, licensed nurses, and nursing assistants across states, provinces, regions, and countries. Methods: Data were collected from Internet searches of staffing regulations and policies along with statistical data on actual staffing from reports and documents. Staffing data were converted to hours per resident day to facilitate comparisons across countries. Findings: We found wide variations in both nurse staffing standards and actual staffing levels within and across countries, although comparisons were difficult to make due to differences in measuring staffing, the vagueness of standards, and limited availability of actual staffing data. Both the standards and levels in most countries ( except Norway and Sweden) were lower than the recommended levels by experts. Conclusions: Our findings demonstrate the need for further attention to nurse staffing standards and levels in order to assure the quality of nursing home care.

  • 2012. Albert Banerjee (et al.). Social Science and Medicine 74 (3), 390-398

    Canadian frontline careworkers are six times more likely to experience daily physical violence than their Scandinavian counterparts. This paper draws on a comparative survey of residential careworkers serving older people across three Canadian provinces (Manitoba, Nova Scotia, Ontario) and four countries that follow a Scandinavian model of social care (Denmark, Finland, Norway, Sweden) conducted between 2005 and 2006. Ninety percent of Canadian frontline careworkers experienced physical violence from residents or their relatives and 43 percent reported physical violence on a daily basis. Canadian focus groups conducted in 2007 reveal violence was often normalized as an inevitable part of elder-care. We use the concept of “structural violence”(Galtung, 1969) to raise questions about the role that systemic and organizational factors play in setting the context for violence. Structural violence refers to indirect forms of violence that are built into social structures and that prevent people from meeting their basic needs or fulfilling their potential. We applied the concept to long-term residential care and found that the poor quality of the working conditions and inadequate levels of support experienced by Canadian careworkers constitute a form of structural violence.Working conditions are detrimental to careworker's physical and mental health, and prevent careworkers from providing the quality of care they are capable of providing and understand to be part of their job. These conditions may also contribute to the violence workers experience, and further investigation is warranted.

  • 2012. Deborah Brennan (et al.). Journal of European Social Policy 22 (4), 377-391

    The use of markets and market mechanisms to deliver care services is growing in both liberal and social democratic welfare states. This article examines debates and policies concerning the marketisation of eldercare and childcare in Sweden, England and Australia. It shows how market discourses and practices intersect with, reinforce or challenge traditions and existing policies and examines whether care markets deliver user empowerment and greater efficiency. Markets for eldercare and childcare have developed in uneven and context specific ways with varying consequences. Both politics and policy history help to shape market outcomes.

  • 2012. Tamara Daly, Marta Szebehely. International Journal of Social Welfare 21 (2), 139-148

    This article aims to contribute to comparative welfare state research by analysing the everyday work life of long-term care facility workers in Canadaand Sweden. The study’s empirical base was a survey of fixed and open-ended questions. The article presents results from a subset of respondents (care aides and assistant nurses) working in facilities in three Canadian provinces (n = 557) and across Sweden (n = 292). The workers’ experiences were linked to the broader economic and organisational contexts of residential care in the two jurisdictions.We found a high degree of country-specific differentiation of work organisation:Canada follows a model of highly differentiated task-oriented work, whereasSweden represents an integrated relational care work model. Reflecting differences in the vertical division of labour, the Canadian care aides had more demanding working conditions than their Swedish colleagues. The consequences of these models for care workers, for older people and for their families are discussed.

  • 2012. Marta Szebehely. Jämlik ålderdom?
  • 2012. Marta Szebehely, Petra Ulmanen.

    Rapporten undersöker hur den svenska äldreomsorgen har förändrats över tid. Hur har förändringarna påverkat de äldre, och hur har de påverkat deras anhörigas förvärvsarbete? Vi bygger på nya analyser av SCB:s stora intervjustudier av befolkningens levnadsförhållanden (ULF), samt tidigare svensk och internationell forskning. Vi jämför förändringarna under 1980- och 1990-talen med förändringarna under 2000-talet.

  • 2011. Marta Szebehely. Konkurrensens konsekvenser, 215-257
  • 2011. Tamara Daly (et al.). Canadian Journal on Aging 30 (2), 271-284

    We conducted a mixed-methods study – the focus of this article – to understand how workers in long-term care facilities experienced working conditions. We surveyed unionized care workers in Ontario (n = 917); we also surveyed workers in three Canadian provinces (n = 948) and four Scandinavian countries (n = 1,625). In post-survey focus groups, we presented respondents with survey questions and descriptive statistical fi ndings, and asked them: “Does this reflect your experience?” Workers reported time pressures and the frequency of experiences of physical violence and unwanted sexual attention, as we explain. We discuss how iteratively mixing qualitative and quantitative methods to triangulate survey and focus group results led to expected data convergence and to unexpected data divergence that revealed a normalized culture of structural violence in long-term care facilities. We discuss how the finding of structural violence emerged and also the deeper meaning, context, and insights resulting from our combined methods.

  • 2010. Marta Szebehely. Gerontologi 26 (3), 20-21
  • 2010. Marta Szebehely. International symposium on working family carers. Conference proceedings. National Yang-Ming University, Taipei, Taiwan
  • 2010. Marta Szebehely. Tiden - Socialdemokratisk idé- och debattidskrift (3)
  • 2010. Marta Szebehely. Global kris - håller välfärdssystemen?, 77-90
  • 2010. Marta Szebehely. Tiden - Socialdemokratisk idé- och debattidskrift (2)
  • 2009. Marta Szebehely, Petra Ulmanen.
  • 2009. Evy Gunnarsson, Marta Szebehely.
  • 2009. Evy Gunnarsson, Marta Szebehely. Genus i omsorgens vardag, 11-26
  • 2008. Marta Szebehely, Gun-Britt Trydegård.

    Care services for disabled and elderly persons are essential parts of the Nordic wel¬fare states. While these services are often not separated in statistics and research, a comparison reveals sub¬stantial differences in Sweden. This paper focuses on the recent develop¬ment of the two services and its consequen¬ces for the parties concerned: the elderly and disabled persons, their next of kin and the care staff.

    The analyses show that the financial resources for elder care have declined in relation to the increasing number of old people, while the resources for disabil¬ity care have increased substantially.

    The boundary line bet¬ween formal and informal care has changed partly in opposite directions. There is a trend of informali¬sation among elderly people, especially those with lower education, while there is an opposite trend towards more formal care among disabled persons with large needs of assistance.

    The care workers in the two services report very different working conditions, e.g. regarding their workload and the possibility to meet the users' care needs.

    In relation to the Nordic welfare state model, care services for elderly and for disab¬led people in Sweden seem to be moving in different directions. An increasing number of disabled people with extensive care needs can lead their lives with greater autonomy and less family dependency than previously. Among frail elderly people, decreasing public support and increasing, often coerced, family dependency, might instead be a sign of a departure from the Nordic model.

  • 2008. Rolf Å Gustafsson, Marta Szebehely. Paid Care in Australia: Politics, Profits, Practices
  • 2008. Rosmari Eliasson-Lappalainen, Marta Szebehely. Forskningsmetodik för socialvetare
  • 2008. Marta Szebehely, Petra Ulmanen. Välfärd: SCB:s tidskrift om arbetsliv, demografi och välfärd (2), 12-14
  • 2008. Albert Banerjee (et al.).
  • 2007. Marta Szebehely. Annual Espanet Conference, Social Policy in Europe
  • 2007. Petra Ulmanen, Marta Szebehely. Expressen (30 maj)

    Pressen att vårda sina gamla föräldrar har ökat bland döttrarna till lågutbildade äldre. Våra nya beräkningar visar att närmare 60 000 kvinnor i dag har gått ner till deltid eller lämnat sitt förvärvsarbete helt för att kunna vårda gamla eller sjuka anhöriga. Välbärgade medelålders kvinnor kan med det nya skatteavdraget köpa billig hushållshjälp till sina föräldrar. Det kan inte arbetarklassen. Nya avdragen för hushållsnäratjänster gynnar då jämställdheten bara för de rika. Det skriver i dag professor MARTA SZEBEHELY och doktorand PETRA ULMANEN vid Institutionen för socialt arbete, Stockholms universitet.

Visa alla publikationer av Marta Szebehely vid Stockholms universitet

Senast uppdaterad: 28 maj 2018

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