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  • 1.
    Berglund, Mia
    et al.
    University of Skövde.
    Westin, Lars
    University of Skövde.
    Svanström, Rune
    University of Skövde.
    Sundler J, Annelie
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Suffering caused by care--patients' experiences from hospital settings.2012In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 7, no 1Article in journal (Refereed)
    Abstract [en]

    Suffering and well-being are significant aspects of human existence; in particular, suffering and well-being are important aspects of patients' experiences following diseases. Increased knowledge about existential dimensions of illness and healthcare experiences may be needed in order to improve care and reduce unnecessary suffering. Therefore, the aim of this paper is to illuminate the phenomenon of suffering experienced in relation to healthcare needs among patients in hospital settings in Sweden. In this study, we used a reflective lifeworld approach. The data were analysed with a focus on meanings. The results describe the essential meaning of the phenomenon of suffering in relation to healthcare needs. The patients were suffering during care-giving when they felt distrusted or mistreated and when their perspective on illness and health was overlooked. Suffering was found to arise due to healthcare actions that neglected a holistic and patient-centred approach to care. Unfortunately, healthcare experiences that cause patients to suffer seem to be something one needs to endure without being critical. The phenomenon can be described as having four constituents: to be mistreated; to struggle for one's healthcare needs and autonomy; to feel powerless; and to feel fragmented and objectified. The study concludes that there are problems associated with patients experiencing suffering at the hands of healthcare providers, even if this suffering may not have been caused deliberately to the patient. Consequently, conscious improvements are needed to lessen the suffering caused by care-giving, as are strategies that promote more patient-centred care and patient participation.

  • 2.
    Björk Brämberg, Elisabeth
    et al.
    University of Borås, School of Health Science.
    Nyström, Maria
    University of Borås, School of Health Science.
    To be an immigrant and a patient in Sweden: A study with an individualised perspective2010In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 5, no 3, p. 1-9Article in journal (Refereed)
    Abstract [en]

    The aim is to describe how experiences of being an immigrant can influencethe situation when becoming a patient in Swedish health care. A hermeneutic approach was used. Sixteen persons born in non-Nordic countries were interviewed. The data was analysed with an empirical hermeneutical method. The findings indicate that positive experiences (i.e., establishing oneself in a new home country) enhance the possibilities of taking part in caring situations and vice versa. Hence, there is a need for individually adapted care that takes one's whole life situation into consideration. Consequently, it is suggested that the concept, “cultural competence” merely serves the purpose of illuminating caregivers’ need for categorisation. It does not illuminate individual needs in a caring situation.

  • 3.
    Björk Brämberg, Elisabeth
    et al.
    University of Borås, School of Health Science.
    Nyström, Maria
    University of Borås, School of Health Science.
    Dahlberg, Karin
    Patient participation: A qualitative study of immigrant women and their experiences2010In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 5, no 1Article in journal (Refereed)
    Abstract [en]

    Patient participation in healthcare is a neglected area of interest in the rather extensive amount of research on immigrant so-called Selma patients in Swedish health care as well as worldwide. The aim is to explore the phenomenon ‘‘patient participation’’ in the context of the Swedish health care from the perspective of immigrants non-fluent in Swedish. A phenomenological lifeworld approach was chosen. Data were collected from patients within a municipal home care setting in Sweden. Eight women agreed to participate. In seven interviews, an interpreter was necessary for the translation of the interview. Five authorized interpreters were used. Data were analysed in accordance to a descriptive phenomenological method for caring research. The analysis led to an essence of the phenomenon with three constituents, ‘‘to experience participation,’’ ‘‘to refrain from participation,’’ and ‘‘to be deprived of participation.’’ Patient participation from the perspective of immigrant women means that patients are involved and active in their own health and caring processes. For these women, it is particularly important to have the opportunity to express themselves. Patient participation presupposes professional caregivers who act in a way that increases the patients’ opportunities to take part. A skilled interpreter is often necessary in order to enable the patient participation.

  • 4.
    Bondas, Terese
    et al.
    University of Borås, School of Health Science.
    Berg, Marie
    Hall, Elisabeth
    Olafsdottir, Olöf Asta
    Störe Brinchmann, Berit
    Vehviläinen-Julkunen, Katri
    Evidence-based care and childbearing: a critical approach2008In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 3, no 4, p. 239-247Article in journal (Refereed)
    Abstract [en]

    Developing the best care for clients and patients is a paramount aim of all health care practices, which therefore, should be based on best evidence. This is also crucial for care during the childbearing period here defined as pregnancy, childbirth, and infancy. However, due to dominance of the evidence-based medicine (EBM) model, health care practice has encountered problems especially regarding its relationship to qualitative research. In this article, we analyze and discuss how research based on a lifeworld perspective fits with evidence-based care (EBC), and how a circular model instead of a hierarchy is suitable when attributing value to knowledge for EBC. The article focuses on the history of EBM and EBC, the power of the evidence concept, and EBC from a narrow to a broad view. Further qualitative research and its use for developing EBC is discussed and examples are presented from the authors’ own lifeworld research in the Nordic childbearing context. Finally, an alternative circular model of knowledge for EBC is presented. In order to develop evidence-based care, there is need for multiple types of scientific knowledge with equal strength of evidence, integrated with clinical experience, setting, circumstances and health care resources, and incorporating the experiences and clinical state of the childbearing woman and her family.

  • 5.
    Bondas, Terese
    et al.
    University of Borås, School of Health Science.
    Hall, Elisabeth
    A decade of metasynthesis research in health sciences: a meta-method study2007In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 2, no 2, p. 101-113Article in journal (Other academic)
    Abstract [en]

    The overall aim of this study was to analyze the methods applied in previous metasynthesis research and to inform future researchers of epistemological and methodological issues based on this analysis. Meta-method analysis was applied to a decade of 45 published metasynthesis studies that pertain to nursing and allied health studies. The findings show that the metasynthesis research can be classified into three areas: (1) health, illness and suffering, (2) care and support, and (3) parenting, newborn and childcare. Meta ethnography dominates the research area. Metastudy, metasummary, qualitative metasynthesis, and grounded formal theory are emerging methods. The metasynthesis studies suffer from modifications without explications, use of secondary method references, missing sample and search data and differences in the type of findings and the meta-concepts depicting the findings. The worth of metasynthesis research is questioned when the core ideas of qualitative meta studies, theoretical and/or methodological development (‘‘synthesis’’) combined with the potential of going beyond and behind the studies (‘‘meta’’), is missing. Metasynthesis research requires knowledge in both the substance and the various qualitative methods, and systematic attendance to the method accompanied by the openness and the creativity of a qualitative approach. Conclusions and recommendations are presented as epistemological reflections and a guide for future metasynthesis research in health sciences.

  • 6.
    Dellve, Lotta
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Hallberg, L R-M
    “Making it work in the frontline” explains female home care workers´ defining, recognising, communicating and reporting of occupational disorders2008In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, ISSN 1748-2623, Vol. 3, no 3, p. 178-184Article in journal (Refereed)
    Abstract [en]

    Epidemiological research has so far failed to explain the high incidence of occupational disorders among home care workers (HCWs) and the great differences in organizational incidence rate. A qualitative approach may contribute to a deeper understanding of work group reasoning and handling in a more contextual manner. The aim of this grounded theory study was to gain a deeper understanding of the main concern in the processes of recognizing, communicating and reporting occupational disorders among HCWs. Focus group interviews were conducted with 40 HCWs in 9 focus groups. The selected municipalities represented variations in municipality type and incidence rate of occupational disorders. Making it work in the frontline was identified as the core category explaining that the perceived work situation in home care work was the main concern but interacted with work-group socialising processes as well as with the communicability and derivability of the occupational disorder when defining and reporting occupational disorders. Complex problems could be reformulated and agreed within the workgroup to increase communicability. Described significances for reporting/non-reporting were related to financial compensation, to a part of organizational political game or to an existential uncertainty, i.e. questioning if it belonged to their chosen work and life. Our conclusion is that working situation and work group attitudes have importance for reporting of occupational disorders. To support work-related health for HCWs, integrating communication should be developed about work-related challenges in work situation, as well as about attitudes, culture and efficiency within work-group.

  • 7.
    Dellve, Lotta
    et al.
    Sahlgrenska Academy, Göteborg University.
    Morberg, S
    Karolinska Institute.
    Karlsson, B
    Karolinska Institute.
    Lageström, M
    Karolinska Institute.
    Constructed space and legitimacy for health work in the educational system: Perspectives of school nurses2006In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, ISSN 1748-2623, Vol. 1, no 4Article in journal (Refereed)
    Abstract [en]

    Increasing health problems among children place demands on school health care. It is unclear how contextual issues, e.g. reduced resources and low priority, impact the practising of health care work within the educational system. The aim was to gain a deeper understanding of school nurses' perceptions of their opportunities for practising and handling health support work within the educational system. A qualitative study in line with constructivist grounded theory based on data from six focus group interviews with 24 school nurses. The results explain the conditions in which school nurses practise health support work within the educational system, as described in a conceptual model. The core category in the model was labelled construction of space and legitimacy for individual health support work within the educational setting. The model comprised four additional categories: experiencing restricted conditions for practising health support work; working alone and in isolation: retaining individual health support; and compromising and negotiating position and legitimacy. Interests and positions of political and organisational leaders, the school personnel and children/parents, as well as the school nurse's own strategies, constructed a limited space and legitimacy for health support work. Key words: School health care, health support, health work, school nurse, psychosocial work environment

  • 8.
    Eskilsson, Camilla
    et al.
    University of Borås, School of Health Science.
    Carlsson, Gunilla
    University of Borås, School of Health Science.
    Feeling confident in burdensome yet enriching care: Community nurses describe the care of patients with hard-to-heal wounds2010In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 5, no 3, p. 9-Article in journal (Refereed)
    Abstract [en]

    Treating patients with hard-to-heal wounds is a complex task that requires a holistic view. Therefore this study focuses on the nurse's perspective with the aim on describing how community nurses experience the phenomenon the care of patients with hard-to-heal wounds. The method used was a reflective lifeworld approach. Seven qualitative interviews with community nurses were conducted. The findings show a tension between enriching and burdensome care. In this tension, the nurses try to find energy to reach harmony in their work through reflection, acceptance, and distance. This is further described by the constituents: “taking responsibility,” “showing respect for the whole person,” “being confident in order to offer confidence,” “seeing time and place as important.” The discussion highlights the importance for a nurse to find how to give ideal care in one's duty but not beyond it. As a consequence the concept “compliance” needs to be challenged in order to promote confidence and mutual trust between nurses and patients. Confidence can be seen as a key, both for nurses and patients, and is dependent on good inter-professional cooperation, competence, and closure.

  • 9. Friberg, Febe
    et al.
    Öhlen, Joakim
    Searching for knowledge and understanding while living with impending death: a phenomenological case study2007In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 2, no 4, p. 217-226Article in journal (Refereed)
    Abstract [en]

    In this article, expression of the quest for knowledge and understanding while living with the threat of fatal cancer is explored. By means of a case study, recurrent narrative interviews and participant observations were performed with one 71-year-old man and the oncology nurse taking care of him. The data were analysed phenomenologically and the results disclose three paths during the illness trajectory at the end-of-life; the stable path, the turning point and the waiting. Existential uncertainty is managed in the stable path, while confronting existential uncertainty is characterized by the turning point, and there is a shift towards living existential certainty during the waiting. The significance of openness towards the intertwinement of the experiential and existential dimensions of living in end-of-life care is emphasized. Research into patients' multidimensional learning at the end of life is needed in order to expand knowledge of how the patient makes sense of their situation particularly in relation to the information they receive from palliative care professionals

  • 10. Hammarlund, K.
    et al.
    Lundgren, Ingela
    University of Borås, School of Health Science.
    Nyström, Maria
    University of Borås, School of Health Science.
    In the heat of the night it is difficult to get it right: teenager's attitudes and values toward sexual risk-taking2008In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 3, no 2, p. 103-112Article in journal (Refereed)
    Abstract [en]

    This study, using a hermeneutic approach, is based on data from four focus group interviews with 25 Swedish teenagers participating, ranging from 18-19 years of age. The aim is to gain a deeper understanding of teenagers' values and attitudes towards sexually transmitted infections (STIs) and sexual risk-taking. The teenagers seem to seek an excuse to fend off responsibility and deny their sexual risk-taking, an excuse provided by drunkenness. Under the influence of alcohol, teenagers are not too shy to have sex but remain embarrassed to talk about condom use. It seems as though the dialogue feels more intimate than the intercourse when it comes to protecting ones sexual health. To be able to act out in this sexual risk-taking the teenager often views the partner in a one-night-stand as an object, as opposed to a love relationship where they view their partner as subject, a person they care for. Engaging in sexual risk-taking often starts at a club where the teenagers go out to socialize and drink alcohol. They then play a game and a part of the game is to pretend that they do not play a game. In this game, certain rules are to be followed and the rules are set up by the girl, mainly to protect the romantic image of being carefully selected and thereby protected from being stigmatized as “sluts” or “whores”.

  • 11. Hörberg, Ulrica
    et al.
    Ozolins, Lise-Lotte
    Ekebergh, Margaretha
    University of Borås, School of Health Science.
    Intertwining caring science, practice and caring education from a lifeworld perspective: two contextual examples2011In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 6, no 4Article in journal (Refereed)
    Abstract [en]

    This article describes how caring science can be a helpful foundation for caring practice and what kind of learning support that can enable the transformation of caring science into practice. The lifeworld approach is fundamental for both caring and learning. This will be illustrated in two examples from research that show the potential for promoting health and wellbeing as well as the learning process. One example is from a caring context and the other is from a learning context. In this article, learning and caring are understood as parallel processes. We emphasize that learning cannot be separated from life and thus caring and education is intertwined with caring science and life. The examples illustrate how an understanding of the intertwining can be fruitful in different contexts. The challenge is to implant a lifeworld-based approach on caring and learning that can lead to strategies that in a more profound way have the potential to strengthen the person’s health and learning processes.

  • 12. Johansson, A
    et al.
    Ekebergh, Margaretha
    The Meaning of Well-being and Participation in the Process of Health and Care: Women’s experiences following a myocardial infarction2006In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 1, no 2, p. 100-108Article in journal (Refereed)
    Abstract [en]

    In this article, the researchers explore women's experiences of care and health process following a myocardial infarction (MI), with a particular focus on their experiences of well-being and participation. The phenomenon is illuminated from the approach of reflective lifeworld research, and in order to obtain expressions of the women's lived experience phenomenological interviews were conducted. Participation and well-being are described as an experience of being involved in one's own health process. This entails that the women have the potential to influence and take responsibility for their own lives and their own bodies in a meaningful way for them. Participation is a condition for the women to deal with their health and their lives, and seems to improve the women's sense of well-being. At the same time as they sense a dependency on the health care professionals, they seek autonomy and a situation where they can find a new balance, including "the new" body and insecurity that the MI has brought with it. However, the findings also show that the women's participation in the process of care and health, and their well-being, is a challenge for health care professionals. When the professionals are unable to encounter the women's need of participation and desire to be met in their existential insecurity, well-being is affected. Key words: Caring science, female, heart disease, lifeworld research, patients' perspective.

  • 13.
    Jonasson, Lise-Lotte
    et al.
    University of Borås, School of Health Science.
    Carlsson, Gunilla
    University of Borås, School of Health Science.
    Nyström, Maria
    University of Borås, School of Health Science.
    Prerequisites for sustainable care improvement using the reflective team as a work model2014In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 9, no 23934Article in journal (Refereed)
    Abstract [en]

    A work model for sustainable care improvement is enhanced by a professional approach in whichattitudes, opinions, and discussions are further developed into creative reflection. This requires not only a personal reflective attitude but also a collegial environment, interested in mutual support in morethorough reflection. Optimal conditions for such development occur when there is an organizational structure at the caring unit which makes it possible to intertwine these factors so that they become a natural part of the work climate.

  • 14.
    Jonasson, Lise-Lotte
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare. [external].
    Liss, P-E
    Westerlind, B
    Berterö, C
    Corroborating indicates nurses’ ethical values in a geriatric ward2011In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, ISSN 1748-2623, Vol. 6, no 3, p. 7291-Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to identify nurses’ ethical values, which become apparent through their behaviour in the interactions with older patients in caring encounters at a geriatric clinic. Descriptions of ethics in a caring practice are a problem since they are vague compared with the four principles of autonomy, beneficence, non-maleficence, and justice. A Grounded Theory methodology was used. In total, 65 observations and follow-up interviews with 20 nurses were conducted, and data were analysed by constant comparative analysis. Three categories were identified: showing consideration, connecting, and caring for. These categories formed the basis of the core category: ‘‘Corroborating.’’ In corroborating, the focus is on the person in need of integrity and self-determination; that is, the autonomy principle. A similar concept was earlier described in regard to confirming. Corroborating deals more with support and interaction. It is not enough to be kind and show consideration (i.e., to benefit someone); nurses must also connect and care for the older person (i.e., demonstrate non-maleficence) in order to corroborate that person. The findings of this study can improve the ethics of nursing care. There is a need for research on development of a high standard of nursing care to corroborate the older patients in order to maintain their autonomy, beneficence, and nonmaleficence. The principal of justice was not specifically identified as a visible nursing action. However, all older patients received treatment, care, and reception in an equivalent manner.

  • 15.
    Karlsson, Katarina
    et al.
    University of Borås, School of Health Science.
    Dalheim Englund, Ann-Charlotte
    University of Borås, School of Health Science.
    Enskär, Karin
    Rydström, Ingela
    University of Borås, School of Health Science.
    Parents' perspectives on supporting children during needle-related medical procedures2014In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 9Article in journal (Refereed)
    Abstract [en]

    Children state that among their worst fears during hospitalization are those related to various nursing procedures and to injections and needles. Nurses thus have a responsibility to help children cope with needle-related medical procedures (NRMP) and the potentially negative effects of these. The aim of the study is to describe the lived experience of supporting children during NRMP, from the perspective of nurses. Fourteen nurses took part in the study, six of whom participated on two occasions thus resulting in 20 interviews. A reflective lifeworld research approach was used, and phenomenological analysis was applied. The result shows that supporting children during NRMP is characterized by a desire to meet the child in his/her own world and by an effort to reach the child’s horizon of understanding regarding these actions, based on the given conditions. The essential meaning of the phenomenon is founded on the following constituents: developing relationships through conversation, being sensitive to embodied responses, balancing between tact and use of restraint, being the child’s advocate, adjusting time, and maintaining belief. The discussion focuses on how nurses can support children through various types of conversation and by receiving help from the parents’ ability to be supportive, and on whether restraint can be supportive or not for children during NRMP. Our conclusion is that nurses have to see each individual child, meet him/her in their own world, and decide on supportive actions while at the same time balancing their responsibility for the completion of the NRMP. This work can be described as ‘‘balancing on a tightrope’’ in an unpredictable situation.

  • 16.
    Karlsson, Katarina
    et al.
    University of Borås, School of Health Science.
    Rydström, Ingela
    University of Borås, School of Health Science.
    Dalheim Englund, Ann-Charlotte
    University of Borås, School of Health Science.
    Enskär, K
    Nurses' perspectives on supporting children during needle-related medical procedures.2014In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 9Article in journal (Refereed)
    Abstract [en]

    Children state that among their worst fears during hospitalization are those related to various nursing procedures and to injections and needles. Nurses thus have a responsibility to help children cope with needle-related medical procedures (NRMP) and the potentially negative effects of these. The aim of the study is to describe the lived experience of supporting children during NRMP, from the perspective of nurses. Fourteen nurses took part in the study, six of whom participated on two occasions thus resulting in 20 interviews. A reflective lifeworld research approach was used, and phenomenological analysis was applied. The result shows that supporting children during NRMP is characterized by a desire to meet the child in his/her own world and by an effort to reach the child's horizon of understanding regarding these actions, based on the given conditions. The essential meaning of the phenomenon is founded on the following constituents: developing relationships through conversation, being sensitive to embodied responses, balancing between tact and use of restraint, being the child's advocate, adjusting time, and maintaining belief. The discussion focuses on how nurses can support children through various types of conversation and by receiving help from the parents' ability to be supportive, and on whether restraint can be supportive or not for children during NRMP. Our conclusion is that nurses have to see each individual child, meet him/her in their own world, and decide on supportive actions while at the same time balancing their responsibility for the completion of the NRMP. This work can be described as "balancing on a tightrope" in an unpredictable situation.

  • 17. Larsson, M
    et al.
    Johansson Sundler, A
    Ekebergh, Margaretha
    University of Borås, School of Health Science.
    The influence of living conditions on adolescent girls' health2012In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 7, no 1, p. 1-8Article in journal (Refereed)
    Abstract [en]

    Adolescence is described by the Swedish National Board of Health and Welfare as the healthiest period in life. However, adolescent girls differ in that they self-report that their health decreases with age. The aim of this hermeneutical study was to describe the meaning of living conditions in relation to adolescent girls’ health. Guided by principles of reflective lifeworld research, 15 interviews with adolescent girls were analysed. The result section consists of four narratives with their existential interpretations illustrating different ways of approaching living conditions and their meaning for health and well-being. The narratives are: Approaching everyday life in a balanced way—feeling harmonious; approaching everyday life with ambiguity—feeling confused; approaching everyday life as an intellectual project—striving for control; approaching everyday life as a struggle—feeling forlorn. In addition, a comprehensive understanding was developed by using the lifeworld dimensions: lived body, lived room, lived time, and lived relations. These dimensions may deepen the understanding of important parts of those living conditions which are meaningful for the girls’ health and well-being. By using the dimensions, complex living conditions have been explored and the meaning of different parts clarified. The girls’ thoughts and feelings are often ambiguous and sometimes contradictory, depending on the situation. The health of adolescent girls needs to be understood against the background of their experiences of living conditions. One way to support their health and well-being seems to be to supply them with forums where they can talk about their living conditions.

  • 18. Larsson, Margaretha
    et al.
    Sundler J, Annelie
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Ekebergh, Margaretha
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    The influence of living conditions on adolescent girls' health.2012In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 7, no 1Article in journal (Refereed)
    Abstract [en]

    Adolescence is described by the Swedish National Board of Health and Welfare as the healthiest period in life. However, adolescent girls differ in that they self-report that their health decreases with age. The aim of this hermeneutical study was to describe the meaning of living conditions in relation to adolescent girls' health. Guided by principles of reflective lifeworld research, 15 interviews with adolescent girls were analysed. The result section consists of four narratives with their existential interpretations illustrating different ways of approaching living conditions and their meaning for health and well-being. The narratives are: Approaching everyday life in a balanced way--feeling harmonious; approaching everyday life with ambiguity--feeling confused; approaching everyday life as an intellectual project--striving for control; approaching everyday life as a struggle--feeling forlorn. In addition, a comprehensive understanding was developed by using the lifeworld dimensions: lived body, lived room, lived time, and lived relations. These dimensions may deepen the understanding of important parts of those living conditions which are meaningful for the girls' health and well-being. By using the dimensions, complex living conditions have been explored and the meaning of different parts clarified. The girls' thoughts and feelings are often ambiguous and sometimes contradictory, depending on the situation. The health of adolescent girls needs to be understood against the background of their experiences of living conditions. One way to support their health and well-being seems to be to supply them with forums where they can talk about their living conditions.

  • 19.
    Lindberg, Elisabeth
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Almerud Österberg, Sofia
    Linnéuniversitetet.
    Hörberg, Ulrica
    Linnéuniversitetet.
    Methodological support for the further abstraction of and philosophical examination of empirical findings in the context of caring science2016In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 11Article in journal (Refereed)
    Abstract [en]

    Phenomena in caring science are often complex and laden with meanings. Empirical research with the aim of capturing lived experiences is one way of revealing the complexity. Sometimes, however, results from empirical research need to be further discussed. One way is to further abstract the result and/or philosophically examine it. This has previously been performed and presented in scientific journals and doctoral theses, contributing to a greater understanding of phenomena in caring science. Although the intentions in many of these publications are laudable, the lack of methodological descriptions as well as a theoretical and systematic foundation can contribute to an ambiguity concerning how the results have emerged during the analysis. The aim of this paper is to describe the methodological support for the further abstraction of and/or philosophical examination of empirical findings. When trying to systematize the support procedures, we have used a reflective lifeworld research (RLR) approach. Based on the assumptions in RLR, this article will present methodological support for a theoretical examination that can include two stages. In the first stage, data from several (two or more) empirical results on an essential level are synthesized into a general structure. Sometimes the analysis ends with the general structure, but sometimes there is a need to proceed further. The second stage can then be a philosophical examination, in which the general structure is discussed in relation to a philosophical text, theory, or concept. It is important that the theories are brought in as the final stage after the completion of the analysis. Core dimensions of the described methodological support are, in accordance with RLR, openness, bridling, and reflection. The methodological support cannot be understood as fixed stages, but rather as a guiding light in the search for further meanings.

  • 20.
    Lindberg, Elisabeth
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Ekebergh, M.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Persson, E.
    Lunds Universitet, Medicinska Fakulteten.
    Hörberg, U.
    Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap.
    The importance of existential dimensions in the context of the presence of older patients at team meetings-in the light of Heidegger and Merleau-Ponty's philosophy2015In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 10, p. 1-10Article in journal (Refereed)
    Abstract [en]

    The aim of the present study is to explore interpersonal dimensions of the presence of older patients at team meetings. The theoretical foundation of the study is grounded in caring science and lifeworld phenomenology. The results from two empirical studies, that indicated the need for a more in-depth examination of the interpersonal relationships when an older patient is present at a team meeting, were further explicated by philosophical examination in the light of Heidegger and Merleau-Ponty's philosophy. The empirical studies were performed in a hospital ward for older people, where the traditional rounds had been replaced by a team meeting, to which the patients were invited. The analysis of the general structure and philosophical examination followed the principles of reflective lifeworld research. The philosophical examination is presented in four meaning structures: mood as a force in existence; to exist in a world with others; loneliness in the presence of others; and the lived body as extending. In conclusion, professionals must consider patients' existential issues in the way they are expressed by the patients. Existence extends beyond the present situation. Accordingly, the team meeting must be seen in a larger context, including the patients' life as a whole, as well as the ontological and epistemological foundations on which healthcare is based. ©2015 E. Lindberg et al.

  • 21.
    Lindberg, Elisabeth
    et al.
    University of Borås, School of Health Science.
    Hörberg, Ulrika
    Persson, Eva
    Ekebergh, Margaretha
    University of Borås, School of Health Science.
    It made me feel human. A phenomenological study on older patients´ experiences of participating in a Team meeting.2013In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 8, no 1Article in journal (Refereed)
    Abstract [en]

    This study focused on older patients participating in a team meeting (TM) in a hospital ward in Sweden. A process had taken place on the ward, in which the traditional round had developed into a TM and understanding what participating in a TM means for the older patient is necessary for the development of care that facilitates older patient's participation. The aim of this study was to describe the caring, as experienced by the older patients on a ward for older persons, with a specific focus on the team meeting. A reflective lifeworld research (RLR) design was used. Fifteen patients, 12 women and three men (mean age of 82 years) were interviewed while they were hospitalized in a hospital ward for older people. In the essential meaning of the phenomenon, the TM is described as being a part of a wider context of both caring and life. The need for hospitalization is an emotional struggle to overcome vulnerability and regain everyday freedom. The way in which the professionals are able to confirm vulnerability and create a caring relationship affects both the struggle for well-being and the possibilities for maintaining dignity. The essence is further explicated through its constituents; Vulnerability limits life; Life is left in the hands of someone else; Life is a whole and Space for existence. The result raises concern about how the care needs to be adjusted to older people's needs as lived bodies. The encounter between the carer and the patient needs to be developed in order to get away from the view of the patient as object. An expanded vision may open up for existential dimensions of what brings meaning to life. One way, as described by the patients, is via the patient's life stories, through which the patients can be seen as a whole human being.

  • 22.
    Lindberg, Elisabeth
    et al.
    University of Borås, School of Health Science.
    Persson, Eva
    Hörberg, Ulrica
    Ekebergh, Margaretha
    University of Borås, School of Health Science.
    Older Patients’ Participation in Team Meetings: A phenomenological study from the nurses’ perspective2013In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 8Article in journal (Refereed)
    Abstract [en]

    Although the importance of patient participation is acknowledged in today's healthcare, many challenges remain before patient participation can become an integral part of care provision. The ward round has traditionally been the forum for crucial decisions about patient care, but often with limited possibilities for patient participation. As part of the process of improving patient participation, the round in the present study has been replaced by a team meeting (TM) to which the patient has been invited. The aim of this study is to highlight nurses' experiences of older patients' participation in TMs. The research process was guided by the principles of phenomenological reflective life world research. Data were collected in a Swedish hospital, in a ward specializing in older patients. Nine nurses, who had invited and planned for a patient to participate in TMs and/or had experienced TMs in which patients participated, were interviewed. The essential meaning of patient participation in the TM, as experienced by the nurses, is that patient participation can be supported by a safe relationship in which the patient can make his or her voice heard. Participation is challenged by the patients' vulnerability and by the subordinated role assigned to the patient. The essential meaning is further described by its constituents: "the need for a guide," "patient participation challenged by structures," and "creating space for the whole human being." In conclusion, the nurse plays a core role in guiding the patient in an unfamiliar situation. The meaning of patient participation in the TM needs to be discussed by professionals so that the patient perspective is present.

  • 23.
    Lundgren, Ingela
    et al.
    University of Borås, School of Health Science.
    Karlsdottir, Sigridur Inga
    Bondas, Terese
    University of Borås, School of Health Science.
    Long-Term Memories and Experiences of Childbirth in a Nordic Context: A Secondary Analysis2009In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 4, no 2, p. 115-128Article in journal (Refereed)
    Abstract [en]

    The experience of childbirth is an important life experience for women. However, in-depth knowledge about long-term experiences is limited. The aim of the study was to describe women’s experiences two to 20 years after birth. This study is a part of a meta-synthesis project about childbearing in the Nordic countries. Methodologically, the study was a secondary analysis performed on original data from three selected qualitative studies by the authors, in three Nordic countries, Finland, Iceland and Sweden, and in two different forms of care, birth centre care and standard maternity care. There were 29 participants, both primipara and multiparous women. The result from this study shows that women, in a long-term perspective describe childbirth as an encounter with different participants and the most important is with the midwife. The midwife is also important in connection to the atmosphere experienced during birth. The childbirth experience has a potential to strengthen self-confidence and trust in others or, on the contrary, it can mean failure or distrust. Impersonal encounters linger feelings of being abandoned and alone. This dimension is in particular demonstrated in the description of the woman who had given birth at standard maternity care. The conclusion of this study is that childbirth experience has a potential to strengthen self-confidence and trust in others or on the contrary failure or distrust. Maternity care should be organized in a way that emphasis this aspects of care.

  • 24.
    Norberg Boysen, Gabriella
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Nyström, Maria
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Christensson, Lennart
    Jönköpings universitet.
    Herlitz, Johan
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Wireklint Sundström, Birgitta
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Trust in the early chain of healthcare: lifeworld hermeneutics from the patient's perspective2017In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 12, no 1Article in journal (Refereed)
    Abstract [en]

    Purpose: Patients must be able to feel as much trust for caregivers and the healthcare system at the healthcare centre as at the emergency department. The aim of this study is to explain and understand the phenomenon of trust in the early chain of healthcare, when a patient has called an ambulance for non-urgent condition and been referred to the healthcare centre.

    Method: A lifeworld hermeneutic approach from the perspective of caring science was used. Ten patient participated: seven female and three male. The setting is the early chain of healthcare in south-wetern Sweden.

    Results: The findings show that the phenomenon of trust does not automatically involve medical care. However, attention to the patient's lifeworld in a professional caring relationship enables the patient to trust the caregiver and the healthcare environment. It is clear that the "voice of lifeworld" enables the patient to feel trust.

    Conclusion: Trust in the early chain of healthcare entails caregivers' ability to play attention to both medical and existentioal issues in compliance with the patient's information and questions. Thus, the patient must be invited to participate in assessment and decisions concerning his or her own healthcare, in a credible manner and using everyday language.

  • 25.
    Nyström, Maria
    University of Borås, School of Health Science.
    A Bridge Between a Lonely Soul and the Surrounding World: A study on Existential Consequences of being Closely Related to a person with Aphasia.2011In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 6, no 4Article in journal (Refereed)
    Abstract [en]

    This study illuminates existential consequences of being closely related to a person suffering from aphasia. Seventeen close relatives were interviewed and their narratives were interpreted with inspiration from Ricoeur, Levinas, Husserl, Winnicot, and Maurice Merleau-Ponty. The emerging interpretations resulted in four themes that illuminate a life characterized by lost freedom, staying, a new form of relationship, and growing strong together with others. An overarching theme suggests that a life together with an aphasic person means being used as a bridge between the aphasic person and the surrounding world. Moreover, it illuminates that a close relative to a person with aphasia is a person who does not leave, despite a heavy burden of lonely responsibility. It is concluded that community services need to fulfill their responsibility of providing support to informal caregivers as suggested by the Swedish lawmakers.

  • 26.
    Nyström, Maria
    University of Borås, School of Health Science.
    Aphasia- An Existential Loneliness: A Study of the Loss of the World of Symbols2006In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 1, no 1, p. 38-49Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to analyse the existential consequences of aphasia and the struggle to regain the ability to communicate. Data were collected by means of interviews, published books and diaries from four women and five men, who varied in type of aphasia and time since cerebral lesion. Data were interpreted in accordance with a lifeworld hermeneutic approach. The findings led to six interpretations, which serve as a base for a comprehensive understanding and which indicate that the intentional, non-verbal act when something is recognized as something is not affected by aphasia. Aphasia affects the world of symbols, which is necessary for interaction with others. It is connected, therefore, with feelings of alienation, inferiority and shame in social settings. Losing one’s ability to recognize symbols thus makes it essential to cope with existential loneliness. The outcome, a sense of community or alienation, appears to depend on the quality of interpersonal relations. The results thus demonstrate that interaction and communication are important aspects of professional care giving.

  • 27.
    Palmér, Lina
    et al.
    University of Borås, School of Health Science.
    Carlsson, Gunilla
    University of Borås, School of Health Science.
    Mollberg, Margareta
    University of Borås, School of Health Science.
    Nyström, Maria
    University of Borås, School of Health Science.
    Breastfeeding: An existential challenge—women's lived experiences of initiating breastfeeding within the context of early home discharge in Sweden2010In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 5, no 3Article in journal (Refereed)
    Abstract [en]

    For most Swedish women, breastfeeding is an essential part of the childbearing period. Yet, the meaning of breastfeeding from women's perspective is scantily explored. Therefore, the aim of this study is to describe women's lived experiences of initiating breastfeeding within the context of early home discharge. Eight women, two primiparous, and six multiparous were interviewed within 2 months after birth. A reflective lifeworld research design based on phenomenological philosophy was used during the data gathering and data analysis. The results show that the phenomenon, initiating breastfeeding, in spite of good conditions, i.e., early home discharge, is complex and entails an existential challenge. The essential meaning of the phenomenon is conceptualized as, “A movement from a bodily performance to an embodied relation with the infant and oneself as a mother.” This pattern is further described in its five constituents: “Fascination in the first encounter,” “Balancing the unknown,” “Devoting oneself and enduring the situation,” “Seeking confirmation in the unique,” and “Having the entire responsibility.” Caring for women initiating breastfeeding entails, from a caring science perspective, to help the mother meet insecurity and strengthen confidence to trust her ability to breastfeed the newborn infant. According to these findings, it is suggested in the discussion that it is time for health care professionals to reject the idea of breastfeeding merely as meals or eating for the infant. Instead, they ought to embrace its origin, namely as a way to closeness between mother and infant.

  • 28.
    Palmér, Lina
    et al.
    University of Borås, School of Health Science.
    Carlsson, Gunilla
    University of Borås, School of Health Science.
    Mollberg, Margareta
    University of Borås, School of Health Science.
    Nyström, Maria
    University of Borås, School of Health Science.
    Severe breastfeeding difficulties: an existential lostness as a mother2012In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 7, p. 1-10Article in journal (Refereed)
    Abstract [en]

    A majority of women in Sweden initiate breastfeeding but almost a quarter stop or wean the infant in the first few weeks after birth because of difficulties. In order to develop care that facilitates initiation of breastfeeding and enables mothers to realize their expectations concerning breastfeeding, it is necessary to understand what having severe breastfeeding difficulties means for women who experience them. The aim of this study is to describe the lived experiences of initiating breastfeeding under severe difficulties. A reflective lifeworld research design was used. Eight women, seven primiparous and one multipara, were interviewed within 2 months of giving birth. The essential meaning of the phenomenon is described as "Existential lostness as a mother forcing oneself into a constant fight". This pattern is further explicated through its constituents; shattered expectations, a lost time for closeness, being of no use to the infant, being forced to expose oneself, and gaining strength through sharing. The results show that mothers with severe breastfeeding difficulties feel alone and exposed because of their suffering and are lost in motherhood. Thus, adequate care for mothers should enhance the forming of a caring relationship through sharing rather than exposing.

  • 29. Peilot, Birgitta
    et al.
    Andréll, Paulin
    Samuelsson, Anita
    Mannheimer, Clas
    Frodi, Ann
    Sundler J, Annelie
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Time to gain trust and change--experiences of attachment and mindfulness-based cognitive therapy among patients with chronic pain and psychiatric co-morbidity.2014In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 9, no 1Article in journal (Refereed)
    Abstract [en]

    The treatment of patients with chronic pain disorders is complex. In the rehabilitation of these patients, coping with chronic pain is seen as important. The aim of this study was to explore the meaning of attachment and mindfulness-based cognitive therapy (CT) among patients with chronic pain and psychiatric co-morbidity. A phenomenological approach within a lifeworld perspective was used. In total, 10 patients were interviewed after completion of 7- to 13-month therapy. The findings reveal that the therapy and the process of interaction with the therapist were meaningful for the patients' well-being and for a better management of pain. During the therapy, the patients were able to initiate a movement of change. Thus, CT with focus on attachment and mindfulness seems to be of value for these patients. The therapy used in this study was adjusted to the patients' special needs, and a trained psychotherapist with a special knowledge of patients with chronic pain might be required.

  • 30.
    Rusner, Marie
    et al.
    University of Borås, School of Health Science.
    Carlsson, Gunilla
    University of Borås, School of Health Science.
    Brunt, David
    Nyström, Maria
    University of Borås, School of Health Science.
    A dependence that empowers: the meaning of the conditions that enable a good life with bipolar disorder2010In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 5, no 1, p. 1-8Article in journal (Refereed)
    Abstract [en]

    The extensive suffering related to a complex life situation with bipolar disorder (BD) and the reported difference between care needs and the needs that are actually met implicates that there are still questions about management of life with BD that need to be answered. The present study therefore aims to describe the meaning of the conditions that enable a good life with BD. Ten persons, six women and four men (aged 30 61), diagnosed with BD were interviewed. A reflective lifeworld perspective based on phenomenological philosophy was used. The findings present the essential meaning of the conditions that enable a good life with BD as a dependence that empowers, which is further described by its constituents: ‘‘turning the course of life,’’ ‘‘protecting oneself from running out of energy,’’ ‘‘being needed,’’ ‘‘being oneself through reliable others,’’ ‘‘personal landmarks for navigating through life.’’ A voluntary chosen dependence, as described in the present study, is a new approach of care that enables a good life with BD, while enhancing own power, freedom, and control. The conditions that enable a good life with BD are more than separate supporting measures. Therefore a holistic perspective is preferable while providing care for individuals with BD.

  • 31.
    Rusner, Marie
    et al.
    University of Borås, School of Health Science.
    Carlsson, Gunilla
    University of Borås, School of Health Science.
    Brunt, David
    Nyström, Maria
    University of Borås, School of Health Science.
    Extra Dimensions in all Aspects of Life: The Meaning of Life with Bipolar Disorder2009In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 4, no 3, p. 159-169Article in journal (Refereed)
    Abstract [en]

    Living with Bipolar Disorder (BD) greatly affects the whole life; still the meaning of it is poorly explored from the perspective of the individuals actually living with it. The aim of this study is thus to explore the existential meaning of life with BD. Ten persons, six women and four men, (aged 30 61), diagnosed with BD were interviewed. A reflective lifeworld perspective based on phenomenological philosophy was used. The findings show that living with BD entails experiencing extra dimensions in all aspects of life, expressed in terms of a magnitude and complexity beyond that which is perceived as pertaining to normal life. The essential meaning of the phenomenon is further described by its constituents: ‘‘a specific intensity’’, ‘‘a struggle to understand’’, ‘‘an illness that is intertwined with one’s whole being’’. Living with BD means more for the individual than having episodes of depression and mania and must therefore be understood from a holistic perspective. Adequate care for persons with BD, therefore, includes places for safe and profound reflecting about existential issues, such as identity, trust and self-confidence. The present study recommends the caring services to change their ways to explain and talk about the BD illness.

  • 32.
    Sundler J, Annelie
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Ekebergh, Margaretha
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    The Meaning of Well-being and Participation in the Process of Health and Care: Women’s experiences following a myocardial infarction.2006In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 1, no 2, p. 100-108Article in journal (Refereed)
  • 33. Svanström, Rune
    et al.
    Sundler J, Annelie
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Berglund, Mia
    Westin, Lars
    Suffering caused by care-elderly patients' experiences in community care.2013In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 8, no 1Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Growing old involves many changes in life and implies an increased risks of illness and different forms of disabilities. Life may change in a radical way when a person gets a disease like dementia or moves to a nursing home due to disabilities or needs. In both cases, it often leads to an increased dependency on care where the patient becomes exposed and vulnerable and thereby at a higher risk for experiencing different forms of suffering.

    AIM: The aim of this study was to elucidate and gain a deeper understanding of elderly patients' experiences of suffering in relation to community care in nursing homes and home care services.

    MATERIALS AND METHODS: A lifeworld hermeneutical approach was used. Phenomenological interviews and conversations with an open approach were conducted and analysed with a focus on meanings.

    FINDINGS: The findings were presented in four main themes; an absence of the other in care, an absence of dialogues, a sense of alienation and a sense of insecurity. The findings in this study revealed that persons who were cared for in nursing homes and home care services sometimes were exposed to an unnecessary suffering. The suffering sometimes was caused by various caring actions, that is, unnecessary suffering. The suffering caused by care that aroused was due to caregiver's inability to be present, to show their face, and truly meet the patient.

    CONCLUSION: Suffering from care increased the elderly patients' feelings of insecurity, loneliness, and alienation; this seemed to be the foundation for patients' experiences of being outside a human community. There was a lack of knowledge and understanding about the patient's lifeworld.

  • 34. Vincente, Veronica
    et al.
    Castrén, Maaret
    Sjöstrand, Fredrik
    Wireklint Sundström, Birgitta
    University of Borås, School of Health Science.
    Elderly patients’ participation in emergency medical services when2013In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 8Article in journal (Refereed)
    Abstract [en]

    As organizational changes in the healthcare system are in progress, to enhance care quality and reduce costs, it is important to investigate how these changes affect elderly patients’ experiences and their rights to participate in the choice of healthcare. The aim of this study is to describe elderly patients’ lived experience of participating in the choice of healthcare when being offered an alternative care pathway by the emergency medical services, when the individual patient’s medical needs made this choice possible. This study was carried out from the perspective of caring science, and a phenomenological approach was applied, where data were analysed for meaning. Data consist of 11 semi-structured interviews with elderly patients who chose a healthcare pathway to a community-based hospital when they were offered an alternative level of healthcare. The findings show that the essence of the phenomenon is described as ‘‘There was a ray of hope about a caring encounter and about being treated like a unique human being’’. Five meaningful constituents emerged in the descriptions: endurable waiting, speedy transference, a concerned encounter, trust in competence, and a choice based on memories of suffering from care. The conclusion is that patient participation in the choice of a healthcare alternative instead of the emergency department is an opportunity of avoiding suffering from care and being objectified.

  • 35.
    Wallengren, Catarina
    et al.
    University of Borås, School of Health Science.
    Segesten, Kerstin
    University of Borås, School of Health Science.
    Friberg, Febe
    Struggling for freedom: lived experiences of being a relative of a stroke survivor in the first sex month after hospital discharge2008In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 3, no 4, p. 230-238Article in journal (Other academic)
    Abstract [en]

    The aim of this study was to illuminate the meaning of being a relative of a stroke survivor in the first six months after hospital discharge. The study is a part of a larger research project focusing on pedagogic strategies for relatives of stroke survivors. Qualitative interviews were performed with nine relatives of stroke survivors. The data were analysed by means of phenomenological hermeneutic analysis. In the analysis two main themes emerged; (1) awareness of the irrevocably altered life situation and (2) being strong in the altered life situation, which revealed that relatives are actively involved in “a struggle for freedom”, as they have no wish to adapt to the illness or its consequences. Instead, they want to choose their own way of life and write their own history. For that reason, they try to integrate the illness and its consequences by influencing and changing the stroke survivor, health professionals and their surroundings to suit their own needs. The results contribute to facilitating the health professionals’ work by showing that the relatives are free and independent human beings who have the capacity and power to create their own history. Focus should be directed towards identifying and supporting the relatives capacity to create history, and therefore, health professionals need to heed them.

  • 36. Wikberg, Anita
    et al.
    Bondas, Terese
    University of Borås, School of Health Science.
    A patient perspective in research on intercultural caring in maternity care: A meta-ethnography2010In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 5, no 1, p. 1-15Article in journal (Refereed)
    Abstract [en]

    Abstract The aim of this study is to explore and describe a patient perspective in research on intercultural caring in maternity care. In total, 40 studies are synthesized using Noblit and Hare’s meta-ethnography method. The following opposite metaphors were found: caring versus non-caring; language and communication problems versus information and choice; access to medical and technological care versus incompetence; acculturation: preserving the original culture versus adapting to a new culture; professional caring relationship versus family and community involvement; caring is important for well-being and health versus conflicts cause interrupted care; vulnerable women with painful memories versus racism. Alice in Wonderland emerged as an overarching metaphor to describe intercultural caring in maternity care. Furthermore, intercultural caring is seen in different dimensions of uniqueness, context, culture, and universality. There are specific cultural and maternity care features in intercultural caring. There is an inner core of caring consisting of respect, presence, and listening as well as external factors such as economy and organization that impact on intercultural caring. Moreover, legal status of the patient, as well as power relationships and racism, influences intercultural caring. Further meta-syntheses about well-documented intercultural phenomena and ethnic groups, as well as empirical studies about current phenomena, are suggested.

  • 37.
    Östman, Malin
    et al.
    Göteborgs Universitet.
    Jakobsson Ung, Eva
    Göteborgs Universitet.
    Falk, Kristin
    Göteborgs Universitet.
    Continuity means "preserving a consistent whole" - A grounded theory study.2015In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 10, article id 29872Article in journal (Refereed)
    Abstract [en]

    Living with a chronic disease like chronic heart failure (CHF) results in disruptions, losses, and setbacks in the participants' daily lives that affect health and well-being. By using grounded theory method, we illuminate whether persons with CHF experience discontinuity in life and, if so, what helps them to preserve and strengthen continuity in their daily lives. Thirteen individual interviews and one group interview with five participants, aged 62 to 88 years, were carried out. Through data collection and data analysis, we constructed three concepts that make up a model illustrating the participants' experiences in daily life in relation to corporeality, temporality, and identity: experiences of discontinuity, recapturing approaches, and reconciliation. The first concept, experiences of discontinuity, was constructed from the following categories: the alienated body, the disrupted time, and the threatened self. The second concept, recapturing approaches, consists of categories with continuity creative constructions: repossessing the body, maintaining a façade, seizing the day, restoring the balance of time, and preserving self. These actions are intended to overcome problems and master changes in order to maintain balance in daily life through constructions that recreate normality and predictability. The third concept, reconciliation, was constructed from three categories: feel normal, set to adjust, and be positioned. These categories describe how the participants minimize their experiences of discontinuity by recapturing approaches in order to reconcile with various changes and maintain continuity in daily life. Our findings provide a fresh perspective on continuity that may contribute to the development of significant interventions in continuity of care for persons with CHF. However, continuity requires that healthcare systems support each patient's ability to manage change, reorientation, and adjustment to the new situation in order to make it easier for the patient to create and continue living their daily lives as they desire.

  • 38.
    Östman, Malin
    et al.
    Göteborgs Universitet.
    Ung, Eva Jakobsson
    Göteborgs Universitet.
    Falk, Kristin
    Göteborgs Universitet.
    Health-care encounters create both discontinuity and continuity in daily life when living with chronic heart failure - A grounded theory study.2015In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 10, no 1, article id 27775Article in journal (Refereed)
    Abstract [en]

    Living with chronic heart failure (CHF) often involves lifelong contact with health care, more or less frequently, depending on fluctuating health-generating disruptions in everyday life. To reduce the influence on continuity in life, health-care professionals should preferably focus on supporting patients in managing their daily lives, based on their perspective. The aim of this study was to describe how the interaction in health-care encounters contributes to either continuity or discontinuity in the daily life for persons with CHF. Interviews with 18 participants were carried out, using the grounded theory method, through data collection and analysis. Two core concepts were constructed from data which reveal a model that illuminates the characteristics of the encounters, the actions of health-care professionals and the normative discourse. Patient-centred agenda consists of the categories: "Experiencing a subordinate approach," "Objectifying during the encounter" and "Expected to be compliant." This describes how health-care professionals enhance discontinuity in daily life by using a paternalistic approach in the encounter. Person-centred agenda consists of the categories: "Experiencing an empowering approach," "Person-centredness during the encounter" and "Expected to be capable." It describes how participants perceive that health-care professionals enable them to deal with everyday life which enhances continuity. The findings highlight the importance of health-care professionals' attitudes and communication in encounters with patients. Health care must be designed to support and promote patients' own strategic thinking by strengthening their self-image to enhance continuity in everyday life. The experience of discontinuity is based on the prevailing health-care culture which focuses on disease and medical treatment and regards it as superior to the illness experience in an everyday life context. We therefore strongly suggest a paradigm shift in the health-care organisation and culture in order to support the patients in their efforts to live a meaningful, rich life, in spite of the chronic illness CHF.

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