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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

PURPOSE This study aimed to describe community-dwelling older adults’ perceptions of health and well-being in life after retirement.

METHODS This study is part of a larger project using a mixed-methods design to address lifestyles’ influence on community-dwelling older adults’ health. Individual semi-structured interviews were conducted with 18 older adults in age 70 to 95 years. Data were analysed according to a phenomenographic approach.

RESULTS The results encompass four categories describing variations in community-dwelling older adults’ perceptions of health and well-being after retirement: feeling well despite illness and disease, interacting with and being useful for oneself and others, independently embracing opportunities and engaging in life, and maintaining a healthy lifestyle.

CONCLUSIONS The absence of illness and disease is not a clear prerequisite for a sense of health and well-being. To promote and preserve health and well-being after retirement, older adults strived for—and coached themselves to uphold—a balance in life, focusing on not burdening others. This life orientation after retirement must be acknowledged by society at large, especially from an ageist perspective, and in health and social care to preserve and promote health and well-being.

BREASTFEEDING AND EXPERIENCED EXPOSEDNESS IN PARTNER RELATIONSHIP

Ida Gustafsson RN, RM, Lecturer, PhD-student

Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden

Gunilla Carlsson RN, PhD, Professor

Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden

Katarina Karlsson RN, PhD

Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden

Aleksandra Jarling RN, PhD, Lecturer

Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden

Lina Palmér RN, RM, PhD, Associate Professor, Docent

Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden

Background: About 110 000 children are born in Sweden annually. The vast majority of their mothers wish to breastfeed, and also initiate breastfeeding. An important factor for continued breastfeeding is support, especially from the partner. It is likely that lack of support can lead to perceived vulnerability in the partner relationship. Intimate partner violence (IPV) during pregnancy is in Sweden nearly as common as gestational diabetes and the frequency seems to rise postpartum. IPV is multifaceted and encompasses many types and degrees of violence. In a caring science perspective the experience of vulnerability and/or exposedness in partner relationship during breastfeeding (or breastfeeding desire) risks negatively affecting womens health and well-being, regardless of the reason or degree of exposedness. For care to be caring - that is, support health and well-being - knowledge is needed from the perspective of the exposed women. Previous lifeworld theoretical research has shown that breastfeeding may be experienced as an existential challenge and that exposedness to violence during the childbearing period means a long-lasting embodied experience. In this project, these two phenomena are intertwined into a common phenomenon - Breastfeeding in case of experienced exposedness in a partner relationship.

Aim: The purpose of the PhD-project is to develop in-depth knowledge of existential meanings of breastfeeding in case of experienced exposedness in a partner relationship (Study 1-2), and what it means to be cared for (Study 3), as well as to give care and support in this context (Study 4).

Methods: The project has a reflective lifeworld approach. Data has been collected through lifeworld interviews and written lifeworld stories and will be analyzed using a phenomenological or hermeneutical approach.

Results & Conclusion: The results and conclusions of the first study are expected to be completed in the summer of 2023 and will be presented at the conference.

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.

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.

In this study, we highlight the importance of methodological creativity when researching existential phenomena in caring science. Our intention is to provide epistemological and methodological support that would encourage researchers to be creative when collecting data. One fruitful way to approach creativity involves basing one’s research on the epistemological and methodological ideas of lifeworld research. We will illustrate the usefulness of lifeworld research via examples from empirical caring science research and show how creativity may contribute to a profound understanding of patients’ experiences. Hopefully, this article will help other researchers be creative without losing epistemological foundations and scientific validity.

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.

Introduction

Young men may struggle in life with challenges of various concerns about their identity and who they want to be in life. Many health issues arise from social norms and wider societal determinations and for today’s young men, following such norms poses a risk of losing oneself. An essential part of health are connected to the existential dimensions in life and concerns who you are, and how well you know and understand yourself. However; little is known about what it means for young men to live a life with existential concerns.

Purpose and method

The purpose of this phenomenological study, based on reflective lifeworld research (RLR), is to describe young men’s experiences of living with existential concerns for which they have sought support. Eight lifeworld interviews were conducted.

Results

The results essentially show that young men living with existential concerns describe their situations as living close to a bottomless darkness. This is further described according to four constituents: enduring everyday life, striving for a solution, hearing an inner self-critical voice, and wearing a hard shell.

Conclusion

We conclude that strengthening young men’s health processes requires healthcare professionals to create an atmosphere where young men feel safe talking about existential concerns without feeling exposed and vulnerable.

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.

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

Background 

What enables well-being when experiencing existential concerns as a young adult is an under-explored area of research. In order to address young adults’ existential concerns and provide caring support that builds their resilience to meet life challenges, the aim of the present study is to describe the meaning of enabling well-being as experienced by young adults living with existential concerns. 

Method 

This phenomenological study is based on a reflective lifeworld research. Seventeen young adults, nine women and eight men aged 17–27 years, were interviewed. The results is presented in an essential meaning and further explored with its variations and individual nuances of the phenomenon; enabling well-being.  

Ethics  

The study followed the research principles described in the Helsinki Declaration and the Swedish Research Ethics Guidelines. 

Result 

The essential meaning of enabling well-being, when experiencing existential concerns as a young adult, means finding a place to rest. Finding a place to rest means finding both movement and stillness in life to reflect upon one’s life story in order to understand oneself. The essence is further described in the following constituents: recovering in solitude, sharing one’s life story in everyday life, and reflecting one´s life story in a trusting and caring relationship. 

Conclusion 

This study contributes important knowledge from a caring science perspective to inform caring approaches in nursing. The results show that young adults enable their own well-being in many ways when experiencing existential concerns. When their existential concerns feel overwhelming, they need support from healthcare professionals. When young adults seek professional support, the professionals must be open and focus on the young adults’ life story. 

What enables well-being when experiencing existential concerns as a young adult is an under-explored area of research. In order to address young adults’ existential concerns and provide caring support that builds their resilience to meet life challenges, the purpose of the study is to describe the meaning of enabling well-being as experienced by young adults living with existential concerns. This phenomenological study is based on a reflective lifeworld research. Seventeen young adults, aged 17–27 years, were interviewed. The results is presented in an essential meaning and further explored with its variations and individual nuances of the phenomenon; enabling well-being. The essential meaning of enabling well-being, when experiencing existential concerns as a young adult, means finding a place to rest. Finding a place to rest means finding both movement and stillness in life to reflect upon one’s life story in order to understand oneself. The results also show that young adults enable their own well-being in many ways when experiencing existential concerns. When their existential concerns feel overwhelming, they need support from healthcare professionals. When young adults seek professional support, the professionals must be open and focus on the young adults’ life story to enable well-being. 

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.

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.

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.

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.

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.