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  • 1.
    Carlsson, Gunilla
    University of Borås, School of Health Science.
    Johansson Sundler, Annelie (Editor)
    Roxberg, Åsa (Editor)
    Det nakna vårdandet2008Report (Other academic)
  • 2.
    Carlsson, Gunilla
    University of Borås, School of Health Science.
    Det våldsamma mötet: om hot och våld i psykiatrisk vård.2006Conference paper (Refereed)
  • 3.
    Carlsson, Gunilla
    University of Borås, School of Health Science.
    Det våldsamma mötets fenomenologi: om hot och våld i psykiatrisk vård2004Doctoral thesis, monograph (Other academic)
  • 4.
    Carlsson, Gunilla
    University of Borås, School of Health Science.
    Encounters between aggressive patients and caregivers1999Conference paper (Refereed)
  • 5.
    Carlsson, Gunilla
    University of Borås, School of Health Science.
    Hot och våld i psykiatrisk vård2009In: Psyche – Nordisk tidskrift för psykiatriske sykepleier, Vol. 3, no 1, p. 24-26Article in journal (Other academic)
    Abstract [sv]

    Hot och våld inom vård är idag ett aktuellt område som vi kan ta del av från massmedia med jämna mellanrum. Våldsamma incidenter har identifierats inom all vård både i Sverige och internationellt och kan utgöra ett betydande problem både för personal, medpatienter, anhöriga och för patienten själv. Det finns både en förväntan och ett särskilt ansvar vilande på vårdpersonal. I psykiatrisk omvårdnad förväntas att vårdpersonal kan hantera situationer med inslag av aggression, hot och våld på ett professionellt sätt utan att tillfoga patienten onödigt lidande. Här krävs kunskap men också förståelse inför patienten situation och patientens upplevelser. Forskning inom frågor som rör arbetsmiljö visar att förekomst av hot och våld inom vård kan skapa allvarliga arbetsmiljöproblem. Risker finns för personal att drabbas av långvariga psykosociala problem, vilket kan innebära minskad arbetsglädje, skuld och självanklagelser. När vårdare känner skuld över att inte klara av sitt jobb, anklagar sig själv för att inte våga, kan känslan av professionell inkompetens att misslyckas i sin gärning som vårdare infinna sig.

  • 6.
    Carlsson, Gunilla
    University of Borås, School of Health Science.
    Hot och våld: patienters och vårdares upplevelser av våldsamma möten2009Conference paper (Other academic)
  • 7.
    Carlsson, Gunilla
    University of Borås, School of Health Science.
    Ilska, osäkerhet och känslan av existentiell kränkning2009In: Vårdande vid psykisk ohälsa – på avancerad nivå / [ed] Gunnel Svedberg, Petra Svedberg, Henrika Jormfeldt, Ingela Skärsäter, Lena Wiklund Gustin, Lund: Studentlitteratur AB , 2009, p. 237-254Chapter in book (Other academic)
    Abstract [sv]

    Utgångspunkten är genomgående patientens perspektiv. Efter en historisk tillbakablick på hur det varit att vårdas inom psykiatrin riktas blickarna mot aktuell forskning inom området. Boken tar fasta på olika upplevelser som kan prägla personens värld oberoende av diagnos. Ett vårdvetenskapligt perspektiv på psykisk hälsa lyfts fram liksom livsförståelsens betydelse för hur denna formas.

  • 8.
    Carlsson, Gunilla
    University of Borås, School of Health Science.
    Möten med aggressiva patienter i psykiatrisk vård: en fenomenologisk studie av praktiskt vårdande kunskap1998Conference paper (Refereed)
  • 9.
    Carlsson, Gunilla
    University of Borås, School of Health Science.
    Patients longing for autehentic personal care2006Conference paper (Refereed)
  • 10.
    Carlsson, Gunilla
    University of Borås, School of Health Science.
    Rädsla för att möta våldsamma patienter med psykisk ohälsa2007Conference paper (Other academic)
  • 11.
    Carlsson, Gunilla
    University of Borås, School of Health Science.
    The encounters with aggressive patients in psychiatric care: A Phenomenological Study1997Conference paper (Refereed)
  • 12.
    Carlsson, Gunilla
    University of Borås, School of Health Science.
    Uncovering Tacit Caring Knowledge2002Conference paper (Refereed)
  • 13.
    Carlsson, Gunilla
    University of Borås, School of Health Science.
    Våldsamma möten2008In: Rättspsykiatriskt vårdande : vårdande av lagöverträdare med psykisk ohälsa / [ed] Sjögren Reet, Studentlitteratur , 2008, p. 129-155Chapter in book (Other academic)
  • 14.
    Carlsson, Gunilla
    University of Borås, School of Health Science.
    Vård som berör: en studie av våldsamma möten inom psykiatrisk vård2007In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 27, no 3, p. 29-34Article in journal (Refereed)
  • 15.
    Carlsson, Gunilla
    University of Borås, School of Health Science.
    Svensson, Leif (Editor)
    Vårdvetenskaplig analys av våldsamma möten inom ambulanssjukvård2009In: Prehospital akutsjukvård, Stockholm: Liber , 2009, p. 48-54Chapter in book (Other academic)
  • 16.
    Carlsson, Gunilla
    et al.
    University of Borås, School of Health Science.
    Dahlberg, Karin
    Dahlberg, H
    Ekebergh, Margaretha
    University of Borås, School of Health Science.
    Patients longing for authentic personal care: A phenomenological study of violent encounters in psychiatric settings2006In: Mental Health Nursing, ISSN 1353-0283, Vol. 27, no 3, p. 287-305Article in journal (Refereed)
    Abstract [en]

    This article focuses on patients' violence against caregivers. Several studies show that violence and threats within the health care setting are an increasing problem. Encounters that become violent have been the issue of many debates but the phenomenon is still not fully understood. It is important to understand the course of events in violent encounters, both for the sake of the patients and the caregivers' well-being. The aim of this study was to describe the essence of violent encounters, as experienced by nine patients within psychiatric care. Guided by a phenomenological method, data were analyzed within a reflective lifeworld approach. The findings explicate violent encounters characterized by a tension between “authentic personal” and “detached impersonal” caring. “Authentic personal” patients are encountered in an undisguised, straightforward, and open way, and they sense unrestricted respect that caregivers would show another human being. In these encounters violence does not develop well. However, in caring that is “detached impersonal,” the encounters are experienced by the patients as uncontrolled and insecure. These encounters are full of risks and potential violence.

  • 17.
    Carlsson, Gunilla
    et al.
    University of Borås, School of Health Science.
    Dahlberg, Karin
    Drew, N
    Nyström, Maria
    University of Borås, School of Health Science.
    Violent encounters in psychiatric care: a phenomenological study of embodied caring knowledge2004In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 25, no 2, p. 191-217Article in journal (Refereed)
    Abstract [en]

    This article focuses on encounters that become violent, a problem in health care that has been the issue of many debates but is still not fully understood. Violent encounters refer to events where the patient expresses an aggressive and hostile attitude toward the caregiver. This study is part of a bigger project that aims to elucidate violent encounters from the caregivers' as well as the patients' perspectives. The purpose of this particular study was to describe the essence of violent encounters from the caregivers' perspective. Guided by a phenomenological method, data were analyzed within a reflective lifeworld approach. The essence of a violent encounter between caregivers and patients, as experienced by the caregivers, is a critical moment characterized by a tension between presence and distance, a moment where everything is happening at the same time. There are important meaning differences in relation to the violent encounter being viewed as positive rather than negative, based on the caregivers' ability to be present and their capacity in these trying situations to manage their fear. The findings also make explicit the particular knowledge that is needed for the caregiver to manage the threat of violence in a creative way.

  • 18.
    Carlsson, Gunilla
    et al.
    University of Borås, School of Health Science.
    Dahlberg, Karin
    Drew, Nancy
    Encountering Violence and Aggression in Mental Health Nursing: A Phenomenological Study of Tacit Caring Knowledge2000In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 21, no 5, p. 533-545Article in journal (Refereed)
    Abstract [en]

    Violence is a growing psychosocial problem in the health care working environment. Literature shows that nurses are physically assaulted, threatened, and verbally abused more often than other professionals. However, some nurses are able to relate to clients in a way that produces positive resolution. This study explored the phenomenon of positive encounters with aggressive and violent clients. Guided by a phenomenological method, data were analyzed within a lifeworld perspective. The essential meaning of the phenomenon of caregivers' experiences of encountering violent clients is described as an "embodied moment," which is explicated by seven themes of meaning, "respecting one's fear and respecting the client," "touch," "dialogue," "situated knowledge," "stability," "mutual regard," and "pliability." The authors discuss the meaning of the outcome and propose both theory and praxis-oriented activities toward decreasing aggression and violence in health care.

  • 19.
    Carlsson, Gunilla
    et al.
    University of Borås, School of Health Science.
    Dahlberg, Karin
    Lützen, Kim
    Uncovering Tacit Caring Knowledge2002In: Nursing Philosophy, ISSN 1466-7681, E-ISSN 1466-769X, Vol. 3, no 2, p. 144-151Article in journal (Refereed)
    Abstract [en]

    The aim of this article is to present re-enactment interviewing and to propose that it can be used to reveal tacit caring knowledge. This approach generates knowledge not readily attainable by other research methods, which we demonstrate by analysing the epistemological and methodological underpinnings of re-enactment interviewing. We also give examples from a study where re-enactment was used. As tacit knowledge is often characteristic of care, re-enactment interviewing has the potential to engage the informant in a holistic mode and thereby reveal wisdom of the body. When the care provider recalls an event, the details are articulated, which contributes to in-depth data, which subsequently serves as a basis for trustworthy analysis.

  • 20.
    Carlsson, Gunilla
    et al.
    University of Borås, School of Health Science.
    Hantilson, Ulrica
    Nyström, Maria
    University of Borås, School of Health Science.
    Reflective team -. a clinical intervention for sustainable care improvement2014In: Reflective Practice, ISSN 1462-3943, E-ISSN 1470-1103, Vol. 15, no 3, p. 378-389Article in journal (Refereed)
    Abstract [en]

    The aim of this study is to illustrate conditions for the successful implementation of a work model for sustainable care improvement, called Reflecting Team (RT). For this study team leaders were trained in a caring science education programme to lead the reflective processes, and RTs were introduced into two caring contexts. Within the study professional caregivers involved in the implementation of RT were interviewed, and their statements were interpreted according to a life world hermeneutic approach. Dialectic themes emerged that established four prerequisites for successful implementation of RT. A comprehensive understanding suggests that the lowest common denominator for the four prerequisites is mutual interaction. Thus, an atmosphere of sharing was found to be necessary. The challenge of creating such an atmosphere in a caring unit is the focus of the discussion section.

  • 21.
    Dalheim Englund, Ann-Charlotte
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Carlsson, Gunilla
    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.
    Gillsjö, Catharina
    University of Skövde.
    Eriksson, Irene
    University of Skövde.
    Palmér, Lina
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Life without professional work-perceptionsabout one’s self, interpersonal relations andsocial life after retirement2019In: Healthy Aging Research, Vol. 8, no 1, p. 1-18Article in journal (Refereed)
    Abstract [en]

    The aim of this study is to understand how healthy, older adults in Sweden perceive their life situation after retirement. The study is based on a lifeworld approach, and a phenomenographic method was used. Eighteen participants were interviewed, and data were analysed according to the phenomenographic principle of qualitatively different categories. Two categories were developed. The first category, “perceptions that draw attention inward, towards one’s self”, was further described in three subcategories: Sense of decreased status in society, the desire to keep aging at a distance, and contemplation of one’s own existence. The second category, “perceptions that draw attention outward, away from one’s self” was further described in the following four subcategories: caretaking of family members, involvement in social relationships, finding of deep meaning in animals and nature and engagement with society. In the discussion, the findings are further illuminated through comparisons with concepts such as maturity, wisdom and gerotranscendence, and reflections on the findings ‘relevance to a caring context follow. The conclusion suggests this study can provide knowledge that will allow healthcare providers to bridge the gap between generations in order to provide high-quality care. However, for a more profound caring dialogue, for example, about the end of life, a deeper analysis is required.

  • 22.
    Ekebergh, Margaretha
    et al.
    University of Borås, School of Health Science.
    Eskilsson, Camilla
    University of Borås, School of Health Science.
    Carlsson, Gunilla
    University of Borås, School of Health Science.
    Hörberg, Ulrica
    Caring and learning as intertwined- an educational curriculum challenge2014Conference paper (Refereed)
    Abstract [en]

    Background Caring and learning in clinical educational contexts is characterized by an encounter between lived experiences of the patient and the student’s knowledge and understanding. In other words, it is an encounter between two lifeworlds, which has the potential to create a fruitful tension to develop deep knowledge about the patient’s world that can give direction for practice. We will argue that a particular kind of Caring science knowledge becomes an important tool to support this caring and learning process where the goal is to intertwine lived experiences of health and illness with professional knowing and scientific knowledge. From this perspective is even caring and learning an intertwined phenomenon, and it is this intertwining that enables lifeworld led care. Aim This paper presents a study that illustrate how caring and learning is intertwined from the students’ view in an educational clinical context. Method/design The study was carried out using Reflective Lifeworld Research (RLR) with a phenomenological approach. Lifeworld interviews were conducted with students after their clinical placement on a Dedicated Education Unit (DEU). Result The result shows that the essential meaning of the intertwined phenomenon is a movement where caring and learning fall into place which appears in an atmosphere filled with appealing challenges, but has to be sensitive to the students’ readiness. The atmosphere depends on their sense of security and how they experience confirming and affirming responses. Encountering the patient means that the students can gain a sense of the whole and the theory falls into place. The results also highlight how the student, in this atmosphere, has a desire to find a new role in a personal style. Conclusions On the basis of this study a challenge to the curriculum is presented, that is, to develop didactics and supervision models that use a holistic approach and adopt a reflective attitude upon caring and learning as intertwined and not separated.

  • 23.
    Ekebergh, Margaretha
    et al.
    University of Borås, School of Health Science.
    Horberg, Ulrica
    Carlsson, Gunilla
    University of Borås, School of Health Science.
    Lindberg, Elisabeth
    University of Borås, School of Health Science.
    Eskilsson, Camilla
    University of Borås, School of Health Science.
    Holst, Hanna
    Andersson, Niklas
    University of Borås, School of Health Science.
    The Encounter between Caring Sciences and the Lifeworld: The Art of Making Knowledge Alive and Embodied2012Conference paper (Refereed)
    Abstract [en]

    Scientific knowledge is characterized by abstract descriptions and structures, which are not identical to the lived reality. Scientific knowledge cannot directly be applied on the lived existence, without being transformed and adjusted to the individual’s very complex lifeworld. Learning in caring contexts is an encounter between the scientific knowledge of caring and the learner’s lifeworld. This encounter needs a support that has the potential to bring caring science to life and to start an intertwining process with the lifeworld that creates embodied knowledge. Lifeworld didactics are built on an approach about learning as an individual process and that learning takes its point of departure in the learner’s previous experiences, which accompanies the learning process. The challenges within lifeworld didactics are to be open and sensitive to the learner’s lifeworld and with tact support the development of a reflective attitude in the learning process. Lifeworld didactics strategies are of crucial importance in different caring contexts. This symposium presents three lifeworld led phenomenological research projects that have focused on acquiring caring science knowledge in caring contexts, more precisely it is the encounter between caring science and the lifeworld. The research is within the framework of lifeworld didactics, but the three projects each have a special focus.

  • 24.
    Ekebergh, Margaretha
    et al.
    University of Borås, School of Health Science.
    Hörberg, Ulrica
    Carlsson, Gunilla
    University of Borås, School of Health Science.
    Lindberg, Elisabeth
    University of Borås, School of Health Science.
    Eskilsson, Camilla
    University of Borås, School of Health Science.
    Andersson, Niklas
    University of Borås, School of Health Science.
    Holst, Hanna
    The encounter between Caring Science and the Lifeworld2012Conference paper (Other academic)
    Abstract [en]

    Scientific knowledge is characterized by abstract descriptions and structures which are not identical to the lived reality. Scientific knowledge cannot directly be applied on the lived existence, without being transformed and adjusted to the individual’s very complex lifeworld. Learning in caring contexts is an encounter between the scientific knowledge of caring and the learner’s lifeworld. This encounter needs a support that has the potential to bring caring science to life and to start an intertwining process with the lifeworld that creates embodied knowledge. Lifeworld didactics are built on an approach about learning as an individual process and that learning takes its point of departure in the learner’s previous experiences, which accompanies the learning process. The challenges within lifeworld didactics is to be open and sensitive to the learner’s lifeworld and with tact support the development of a reflective attitude in the learning process. Lifeworld didactics strategies are of crucial importance in different caring contexts. This paper presents three lifeworld led phenomenological research projects that have focused on acquiring caring science knowledge in caring contexts, more precisely it is the encounter between caring science and the lifeworld. The research is within the framework of lifeworld didactics, but the three projects each have a special focus. The first illustrates how the learning and caring processes merge and become an intertwined phenomenon in nursing students’ learning. The research is carried out in Dedicated Educational Units (DEU), within psychiatric and orthopedic care. Three perspectives are illustrated in the project; that of the students, the supervisors and the patients. The overall aim is to develop a supervision model that has the potential to support the students’ learning processes as well as the patients’ caring processes. The second illustrates how the concepts ‘patient perspective’ and ‘patient participation’ can be implemented in a clinical setting for elderly patients in order to improve the quality of care. This project is inspired by Participatory Action Research and is built on collaboration between the university and the health care services. The aim is to develop reflective educational material in terms of filmed drama episodes, based on the result of two studies about elderly patients’ participation in team meetings. The third illustrates the perspective of lifeworld didactics in two phenomenological studies that focus on Students` learning in an encounter with patients and Students` learning on the way to becoming professional - supported by supervision in pairs of students. The findings show patterns of essential meanings that have specific significance in the art of supporting students` learning in clinical education. These are; the significance of responsibility, its extent and shape in relation to the supervisor’s ability to adopt a reflective supervising attitude and to be supportive enough but at the same time to not assume the responsibility. The learning process shows to be a challenge for students, where safety in pairs of students has a great significance when coping with the challenge to learn and develop.

  • 25.
    Eskilsson, C.
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Hörberg, U.
    Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap.
    Ekebergh, M.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Lindberg, E.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Carlsson, G.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Caring and learning intertwined in supervision at a dedicated education unit ‒ a phenomenological study2015In: Reflective Practice, ISSN 1462-3943, E-ISSN 1470-1103, Vol. 16, no 6, p. 753-764Article in journal (Refereed)
    Abstract [en]

    Supervising student nurses in clinical praxis entails dealing with both caring and learning aspects. There is a dearth of research focusing on both the caring and learning aspects in supervision. The present study describes how caring and learning is intertwined in supervision. The study was performed with a Reflective Lifeworld Research approach and analyzed phenomenologically for meanings. Eight interviews were conducted with supervisors on an orthopedic-dedicated education unit. The findings reveal how supervisors constantly move in order to be either close to or standing back, adjusting to the students’ and the patients’ needs. This is described in more detail via the constituents: handling responsibility in constant movement, participating in a new and different way, coexisting with students creates meaning and development. The findings show that a reflective attitude in supervision , clear structure for daily activities, and a lifeworld-led didactics can promote a learning and caring environment. Supervisors’ demanding task requires pauses in order to maintain motivation among supervisors. A mutual link between supervisors, students and patients is crucial in order to create an environment where caring and learning are intertwined. © 2015 Taylor & Francis.

  • 26.
    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.

  • 27.
    Eskilsson, Camilla
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Carlsson, Gunilla
    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.
    Hörberg, Ulrica
    Linnéuniversitetet, Växjö. Institutionen för hälso- och vårdvetenskap.
    Patients' experiences of being cared for by student nurses2015Conference paper (Refereed)
    Abstract [en]

    Background It is crucial for patients to be met by understanding in their vulnerability, to be treated by competence that ensure adequate care and met with an encouraging attitude to participate in their health process. They meet professional careers as well as students, but nevertheless the aim for caring is the same: to provide good and secure care for the patients, all in line with a caring science approach. A limit amount of studies illuminate patients’ experiences of receiving care from student nurses. Aim The aim was to describe how patients perceived being cared for by student nurses, in a clinical context Method The study has been performed with a Reflective Lifeworld Research approach founded on phenomenology. 11 lifeworld interviews were conducted with patients, recently discharged from an orthopedic Dedicated Education Unit. Data have been analyzed for meanings. Results Patients perceive that they are being carried along on the students' learning process like a journey together. This is characterized by a fluctuation between stable and unstable care from the students. Along this journey, patients are in need of a mutual invitation to participation, of genuine encounters, and essential support. Conclusion The patient-student-supervisor relationship is of importance for patients’ experience of being cared for by student nurses in a clinical setting. Genuine encounters between patient and student must be identified and can be stimulated by didactic support and reflection grounded in caring science with a lifeworld perspective. Supervisors have to support to both students and patients in order to create a safe environment in which caring and learning are intertwined. Students require patients in their learning process but patients’ vulnerability, need for participation, genuine encounters and essential support, must be taken into account.

  • 28.
    Eskilsson, Camilla
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Carlsson, Gunilla
    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.
    Hörberg, Ulrica
    Linnéuniversitetet, Växjö, Institutionen för hälso- och vårdvetenskap.
    The experiences of patients receiving care from nursing students at a Dedicatd Education Unit: A phenomenological study2015In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 15, no 5, p. 353-358Article in journal (Refereed)
    Abstract [en]

    The purpose of this study is to describe how patients perceive being cared for by student nurses, in aclinical context in the form of a Dedicated Education Unit (DEU). The study has been performed with aReflective Lifeworld Research (RLR) approach grounded in phenomenology. Lifeworld interviews wereconducted with patients who had received care from student nurses on an orthopaedic DEU and datahave been analysed for meanings. The findings reveal how patients experience to be carried along as apart of the students' learning process. This is described in more detail via the constituents: a mutualinvitation to participate, the importance of genuine encounters, and essential support. Patients experienceboth a stable and a less stable care in a learning environment and it is thus essential for them to beinvited to be a part of both the students' learning process and their own health process. The findings alsohighlight the key role of the supervisors for patients' sense of security. Finally there are indications thatconcepts such as DEU with a lifeworld-led didactic, based on reflection on both the patients' stories andthe students' experiences, can create learning environments that support patients' health processes andalso students’ learning processes.

  • 29.
    Eskilsson, Camilla
    et al.
    University of Borås, School of Health Science.
    Hörberg, Ulrica
    Ekebergh, Margaretha
    University of Borås, School of Health Science.
    Carlsson, Gunilla
    University of Borås, School of Health Science.
    Student nurses’ experiences of how caring and learning is intertwined: A phenomenological study2013In: Journal of Nursing Education and Practice, ISSN 1925-4040, E-ISSN 1925-4059, Vol. 4, no 2, p. 82-93Article in journal (Refereed)
    Abstract [en]

    Background: Clinical studies in nursing education ought to create conditions for the students to link theory to praxis. Previous research in this field focuses on the gap between theory and practice, learning environments, supervision and reflection connected to caring and learning. In addition there are studies that propose the concept of learning and caring as intertwined. The aim of this study is to describe how caring and learning is intertwined from a student perspective. Methods: The study was carried out using Reflective Lifeworld Research (RLR) with a phenomenological approach. Lifeworld interviews were conducted with students after their clinical placement on a Dedicated Education Unit (DEU). Results: The essential meaning is a movement where caring and learning fall into place which appears in an atmosphere filled with appealing challenges, but has to be sensitive to the students’ readiness. The atmosphere depends on their sense of security and how they experience confirming and affirming responses. Encountering the patient means that the students can gain a sense of the whole and the theory falls into place. The results also highlight how the student, in this atmosphere, has a desire to find a new role in a personal style. Conclusions: The study emphasizes the importance of supporting the students in understanding learning and caring as intertwined and not separated. A dualistic approach could harm the students’ aim to get the knowledge embodied. This holistic perspective requires a reflective attitude on caring and learning and has to be further developed in the didactics and supervision.

  • 30.
    Eskilsson, Camilla
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Lindberg, Elisabeth
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Carlsson, Gunilla
    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.
    Hörberg, U.
    Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap.
    Managers' responsibility to support caring and learning in clinical education units2017In: Clinical Nursing Studies, ISSN 2324-7940, E-ISSN 2324-7959, Vol. 5, no 3Article in journal (Refereed)
    Abstract [en]

    Background:Managers in clinical education units (CEUs) have the responsibility to facilitate evidence-based environments for both caring and learning. Promoting such environments might be challenging in times of financial constraints and organisation changes.

    Objective:The purpose of this study was to describe how managers experience their responsibility to support the caring and learning environments in CEUs. 

    Methods:The study method followed the principles of Reflective Lifeworld Research (RLR) grounded in a phenomenological approach. The study was conducted at a hospital in Southern Sweden. Ten first- and second-line managers responsible for CEUs were interviewed. The interviews were conducted as reflective dialogues using an open, and bridled approach.

    Results:The results show that clinical education unit managers regard the responsibility to support caring and learning environments as a challenging experience, elucidated in three themes: (1) to have or to take responsibility; (2) cooperation that supports and challenges; and (3) bringing it all together— a daily struggle.

    Conclusions:In conclusion, the managers of CEUs need to be aware of the importance of common theoretical grounds for caring and learning. Caring and learning are more likely to be intertwined when responsibility is taken, when collaboration between actors is characterised by respect and when an awareness of the importance of reflection is present. Awareness of the importance of creating opportunities for reflection and mutual collaboration among the different actors involved could lead to improvements in nursing education and, therefore, improved patient care.

  • 31. Hörberg, Ulrica
    et al.
    Carlsson, Gunilla
    University of Borås, School of Health Science.
    Holst, Hanna
    Andersson, Niklas
    Eskilsson, Camilla
    University of Borås, School of Health Science.
    Ekebergh, Margaretha
    University of Borås, School of Health Science.
    Lifeworld-led learning takes place in the encounter between Caring Science and the Lifeworld.2014In: Clinical Nursing Studies, ISSN 2324-7940, E-ISSN 2324-7959, Vol. 2, no 3, p. 107-115Article in journal (Refereed)
    Abstract [en]

    Learning in caring contexts could be illustrated as an encounter between the scientific knowledge of caring and the learner’s lifeworld. This encounter needs a support that has the potential to bring caring science to life and to start an intertwining process with the lifeworld that creates embodied knowledge. The aim of this article is to illustrate the meaning of this encounter with help of a theoretical foundation and two examples of research projects with a reflective lifeworld research approach (RLR) founded on phenomenology. Both examples describe the student nurses’ perspective. One illustrates promoting learning through lifeworld-led supervision in pairs of students. The other illustrates learning environments that bridges the gap between theory and practice. These two examples show how the intertwining of caring science theory with lived experience required a certain learning and caring atmosphere that is open and sensitive for the lifeworld. In conclusion, lifeworld-led learning is more than learning per se. Lifeworld theory as a basis for supporting students’ learning could provide both a broadened and deepened understanding of the meaning of learning and also a greater understanding of how to support students’ learning.

  • 32.
    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.

  • 33.
    Keresi, Zuzana
    et al.
    Södra Älvsborgs Sjukhus.
    Carlsson, Gunilla
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Lindberg, Elisabeth
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    A caring relationship as a prerequisite for patient participation in a psychiatric care setting: A qualitative study from the nurses’ perspective2019In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593Article in journal (Refereed)
    Abstract [en]

    The participation of patients in their treatment and care is perceived as desirable; however, patients with mental illnesses experience limited opportunities to participate in their own care. As nurses play a key role in taking care of patients with mental illnesses, this study aimed to investigate how nurses within psychiatric care settings experience patients’ participation and howthey act to increase it. Semi-structured interviews were conducted with eight registered nurses, four of whom worked in apsychiatric institutional care setting and four of whom worked with outpatients. Data were analysed using a qualitative content analysis approach. The analysis identified a theme: a caring relationship is a prerequisite for patient participation. This theme wa sfurther developed through five subthemes. The findings illustrate critical aspects of the caring relationship by which the nurse–patient relationship can either facilitate or impede patient participation. A caring relationship builds trust and increases the patient’s sense of responsibility for their own condition. Because patients with mental illness are cared for in many different contexts, the results of the present study have implications for a broad range of healthcare environments.

  • 34.
    Lundvall, Maria
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Lindberg, Elisabeth
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Hörberg, Ulrica
    Linnéuniversitetet.
    Carlsson, Gunilla
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Palmér, Lina
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Lost in an unknown terrain: a phenomenological contribution to the understanding of existential concerns as experienced by young women in Sweden2019In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of this study is to describe young women’s (16–25 years old) experiences of living with existential concerns for which they have sought support from healthcare professionals, teachers, family, or friends, among others. Methods: This phenomenological study is based on a reflective lifeworld research (RLR) approach. Nine young women were interviewed about their experience of living with existential concerns. Results: The results show the essential meaning of the phenomenon of “existential concerns ”that can be described as living a life that is marked in a profound way by a feeling of being lost in an unknown terrain. To further understand the essential meaning, four constituents are described: the unpredictable body, longing for comprehension, playing a game, and longing to share one’s vulnerability. Conclusions: Young women with existential concerns are vulnerable, as they are profoundly influenced by these concerns. They have to navigate through daily life while trying to fit in and to make their situation comprehensible. These young women have a longing to share their existential concerns with a trustworthy person, while at the same time they fear revealing their existential concerns and risking being rejected by others. A lifeworld-led, caring science approach, intertwined with the results of the present study, has the potential to direct caring practice.

  • 35.
    Lundvall, Maria
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Lindberg, Elisabeth
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Hörberg, Ulrica
    Linnéuniversitetet.
    Palmér, Lina
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Carlsson, Gunilla
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Healthcare professionals’ lived experiences of conversationswith young adults expressing existential concerns2018In: Scandinavian Journal of Caring Sciences, p. 1-7Article in journal (Refereed)
    Abstract [en]

    Introduction:

    This paper describes first-line department healthcare professionals’ experiences of conversations with young adults (16–25 years) who express existential concerns. Existential concerns encompass questions about the meaning of life and the choices people must make, and they are sometimes expressed during the period in which a child is becoming an adult. Sometimes the transition to adulthood can be difficult, and many young adults seek support from people in first-line departments, such as primary care providers, youth guidance centre personnel and student health service employees in high schools and universities. Conversations in which existential concerns are recognised may be important for preventing mental illness in the future.

    Aim:

    The study aimed to describe healthcare professionals’ lived experiences of conversations with young adults who express existential concerns.

    Approach and methods:

    This qualitative study utilises thematic meaning analysis. Interviews were conducted with healthcare professionals working in first-line departments, and data were analysed based on the principles of reflective lifeworld research. The study followed ethical codes of conduct and conformed to the ethical guidelines adopted by the Swedish Research Council.

    Findings:

    The results are presented in three themes of meaning: searching for innermost thoughts requires being present, uncertainty about the unpredictable and awakening of one’s own existential concerns.

    Conclusions and implications:

    Healthcare professionals are affected when young adults express their existential concerns, and they need more support to strengthen their ability to stay present and create inviting atmospheres

  • 36.
    Nyström, Maria
    et al.
    University of Borås, School of Health Science.
    Carlsson, Gunilla
    University of Borås, School of Health Science.
    Dahlberg, Karin
    Non-Caring Encounters at an Emergency Care Unit: A Lifeworld Hermeneutic Analysis of an Efficience Driven Organization2003In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 40, no 7, p. 761-769Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to analyse and describe non-caring encounters at an emergency care unit (ECU). The research approach was life-world hermeneutics, and the research question was: what are the conditions leading to non-caring encounters at an ECU? Nine nurses and nine patients were interviewed. The interpretative analysis reveals an adaptation to organisational demands for efficiency, on the part of both nurses and patients. This form of adaptation seems to constitute a precondition for a well-functioning ECU. Furthermore, a comparison with a study of the intersubjective aspects of caring for aggressive patients reveals unexpected similarities: the carers are absent in both contexts. In nursing education and ECU-practice caring competence must thus include capacity to be present when patients express their needs worries and questions about care.

  • 37.
    Nyström, Maria
    et al.
    University of Borås, School of Health Science.
    Carlsson, Gunilla
    University of Borås, School of Health Science.
    Karlsson, Katarina
    University of Borås, School of Health Science.
    Palmér, Lina
    University of Borås, School of Health Science.
    Creativity in Reflective Lifeworld Research: Empirical examples2013Conference paper (Refereed)
  • 38.
    Nyström, Maria
    et al.
    University of Borås, School of Health Science.
    Carlsson, Gunilla
    University of Borås, School of Health Science.
    Nyberg, Ullakarin
    Larsson Omérov, Pernilla
    Svensson, Leif (Editor)
    Psykisk ohälsa2009In: Prehospital akutsjukvård, Liber, 2009, p. 337-348Chapter in book (Other academic)
  • 39.
    Palmer, Lina
    et al.
    University of Borås, School of Health Science.
    Carlsson, Gunilla
    University of Borås, School of Health Science.
    Brunt, David
    University of Borås, School of Health Science.
    Nyström, Maria
    University of Borås, School of Health Science.
    Existential vulnerability can be evoked by severe difficulties with initial breastfeeding: A lifeworld hermenutical single case study for research on complex breastfeeding phenomena2014In: Breastfeeding Review, ISSN 0729-2759, Vol. 22, no 3, p. 21-32Article in journal (Refereed)
  • 40.
    Palmér, Lina
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Carlsson, Gunilla
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Brunt, David
    Linneuniversitetet.
    Nyström, Maria
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Existential security is a necessary condition forcontinued breastfeeding despite severe initialdifficulties: a lifeworld hermeneutical study2015In: International Breastfeeding Journal, ISSN 1746-4358, E-ISSN 1746-4358, Vol. 10, no 17, p. 1-11Article in journal (Refereed)
    Abstract [en]

    Background:The majority of new mothers in Sweden initiate breastfeeding and many experience initial difficulties. This experience is an important cause of early breastfeeding cessation. To increase understanding, there is a need to explore the lived experiences of the decision to continue or cease breastfeeding. The aim of this study is therefore to explain and understand how this decision is influenced by the meaning of severe initial difficulties.

    Methods: A lifeworld hermeneutical approach was used for the study. The study was conducted in Sweden with eight mothers who experienced severe difficulties with initial breastfeeding. All except one were interviewed on two different occasions resulting in fifteen interviews. The interviews were conducted between 2010 and 2013.

    Results: Mothers who experience severe difficulties with initial breastfeeding feel both overtaken and violated not only by their own infants and their own bodies but also by their anger, expectations, loneliness and care from health professionals. These feelings of being overtaken and invaded provoke an existential crisis and place mothers at a turning point in which these feelings are compared and put in relation to one another in the negotiation of the decision to continue or cease breastfeeding. This decision thus depends on the possibility of feeling secure with the breastfeeding relationship. If insecurity dominates, this can, in severe cases, create a feeling of fear of breastfeeding that is so great that there is no alternative but to stop breastfeeding.

    Conclusions: Existential security in the breastfeeding relationship seems to be an underlying factor for confidence and therefore a necessary condition for continued breastfeeding when having severe initial breastfeeding difficulties. Unresolved feelings of insecurity may be a serious barrier to further breastfeeding that can result in a fear of breastfeeding. Such fear can force the mother to cease breastfeeding. This study highlights how women are situated in a complex cultural and biological context of breastfeeding that has existential consequences for them. An existential crisis forces mothers into a turning point for the breastfeeding decision. In the existential crisis, mothers’ responsibility for the mother-infant relationship guides continuing or ceasing breastfeeding.

  • 41.
    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.

  • 42.
    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 as intertwining between mother and infant2011Conference paper (Refereed)
    Abstract [en]

    For most 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.

  • 43.
    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.
    Initiating breastfeeding: An existential challenge2011Conference paper (Refereed)
    Abstract [en]

    For most 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 in Sweden.

  • 44.
    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.

  • 45.
    Palmér, Lina
    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.
    Carlsson, Gunilla
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Gillsjö, Catharina
    University of Skövde.
    Eriksson, Irene
    University of Skövde.
    Dalheim Englund, Ann-Charlotte
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    The meaning of growing old: A lifeworld hermeneutic study on existential matters during the third age of life2019In: Healthy Aging Research, ISSN 2261-7434, Vol. 8, no 8, p. 1-7Article in journal (Refereed)
    Abstract [en]

    This study investigates existential matters in the third age of life, which encompasses the years after retirement and ends when extensive support needs emerge in the fourth age. As the theoretical starting point in a lifeworld hermeneutic approach, 18 healthy older adults were interviewed about what it means for them to grow old. The interviews were interpreted according to Gadamer’s principles of openness and Ricoeur’s proposal to provide suggestions on how meaning can be explained. The findings are presented in three interpreted themes: Feeling free, Becoming vulnerable, and Existing in closeness to death. The themes are further interpreted, and a comprehensive understanding is reached with theoretical support from Jean-Paul Sartre’s idea of factuality and project. The meaning of growing old is discussed in terms of positive factors, such as healthy aging, transition and gerotranscendence, but also in respect to concerns over future suffering in relation to illness and dependence. It is concluded that the freedom of the third age is greatly appreciated for a healthy life, but also threatened by increased risks of ill health. It is not morbidity in itself that worries most, but the risk of being dependent on care and support from others. This is important to consider when planning and performing care in order to promote a healthy aging.

  • 46. Premberg, Åsa
    et al.
    Carlsson, Gunilla
    University of Borås, School of Health Science.
    Hellström, Anna-Lena
    Berg, Marie
    First-time fathers’ experiences of childbirth: A phenomenological study2011In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 27, no 6, p. 848-853Article in journal (Refereed)
    Abstract [en]

    Objective to describe fathers' experiences during childbirth. Design qualitative method with phenomenological lifeworld approach. A re-enactment interview method, with open-ended questions analysed with a phenomenological method, was used. Participants and setting 10 first-time fathers from two hospitals were interviewed four to six weeks after childbirth in Southwest Sweden during the autumn of 2008. Findings the essential meaning of first-time fathers' lived experience of childbirth was described as an interwoven process pendulating between euphoria and agony. The four themes constituting the essence was: ‘a process into the unknown’, ‘a mutually shared experience’, ‘to guard and support the woman’ and ‘in an exposed position with hidden strong emotions’. Key conclusions childbirth was experienced as a mutually shared process for the couple. The fathers' high involvement in childbirth, in cooperation with the midwife, and being engaged in support and care for his partner in her suffering is fulfilling for both partners, although the experience of the woman's pain, fear of the unknown and the gendered preconceptions of masculine hegemony can be difficult to bear for the father-to-be. Implications for practice in order to maintain and strengthen childbirth as a mutually shared experience for the couple, the father needs to be recognised and supported as a parent-to-be. Midwives have to acknowledge fathers as valued participants and support their significant position.

  • 47.
    Rusner, Marie
    et al.
    University of Borås, School of Health Science.
    Carlsson, Gunilla
    University of Borås, School of Health Science.
    Brunt, D
    Nyström, Maria
    University of Borås, School of Health Science.
    Towards a more liveable life for close relatives of individuals diagnosed with bipolar disorder2012In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, ISSN 1445-8330, Vol. 22, no 2, p. 162-169Article in journal (Refereed)
    Abstract [en]

    The life of close relatives of persons with bipolar disorder (BD) is associated with emotional distress, depression, and a high level of use of mental health care. Illness-related changes of their life situation endanger relationships, social life, finances, and occupational functioning. Understanding of facilitating conditions for close relatives is still a neglected research area. The aim of the present study thus was to explore what makes the life of close relatives of persons with BD more liveable. A lifeworld phenomenological approach was used. The findings reveal that keeping distance, having stability in everyday life, and strengthening equality through transparent communication are conditions that enable close relatives to influence the unpredictable and its consequences and thus make life more liveable. This implies contributions from close relatives, the person with BD, and the caring services. We propose that health-care support should not be divided in support for the patient and/or the close relatives but instead be designed as support for the ‘patient and close relatives’ as a unit. Professional caregivers need to take responsibility for creating intersubjective settings for the person with BD and their close relatives to share their needs and make joint plans for how to influence the illness-related life issues.

  • 48.
    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.

  • 49.
    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.

  • 50.
    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.
    The Paradox of Being Both Needed and Rejected: The Existential Meaning of Being Closely Related to a Person with Bipolar Disorder2012In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, ISSN 0161-2840, Vol. 33, no 4, p. 200-208Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to elucidate the existential meaning of being closely related to a person with bipolar disorder. A qualitative, descriptive, and explorative design with a phenomenological meaning-oriented analysis was used. The findings reveal a paradoxical, existential exposure of close relatives to a person with bipolar disorder, being both needed and rejected whilst being overshadowed by the specific changeable nature of bipolar disorder. Psychiatric health care services are recommended to consider changes in attitudes and structures that may facilitate close relatives’ participation in the care and treatment of persons with bipolar disorder.

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