Experiences of caring after religious disaffiliation: A qualitative study based on the DEW model

BACKGROUND AND AIM

Leaving a religious community may occasionally lead to suffering in a human being's life and difficult existential life issues, such as loss of social relationships, identity and well-being. Only a few studies have been conducted on what kind of care and support human beings who are suffering need in this context. The aim of this study was to increase the understanding of what a human being perceives as caring after religious disaffiliation.

METHODS

In-depth interviews were conducted with 18 participants who had left different religious communities in Finland. The material was analysed through a deductive thematic analysis according to Braun and Clarke, based on the Dressing an existential wound model by Rehnsfeldt and Arman.

RESULTS AND CONCLUSION

The results show that what human beings experience as caring after religious disaffiliation is encountering a care professional who understands the needs of someone in this life situation. Based on these needs, caring is described through seven themes. Care professionals need to understand the impact religious disaffiliation may have on clients' lives and respond to their needs. Understanding the suffering of a human being calls for a care professional's holistic view and caring for the whole human being, including spiritual dimensions. This new knowledge can be used by care professionals to develop caring for clients after religious disaffiliation.

Social robots counselling in community pharmacies - Helping or harming? A qualitative study of pharmacists' views

Background

Welfare technological solutions such as social robots attempt to meet the growing needs of the healthcare sector. Social robots may be able to respond to the shortage of pharmaceutical personnel at community pharmacies. However, there is a lack of previous studies regarding the use of social robots for medication counselling purposes in a pharmacy setting.

Objectives

The objective of this qualitative study was to explore pharmacists' views on the potential role of social robots in medication counselling.

Methods

Pharmacists, purposively sampled based on having recent experience of counselling customers in community pharmacies in Finland, first acted as customers interacting with the social robot in a simulated setting, before taking part in a focus group where their perspectives were explored. The focus group discussions were conducted in October and November 2022. The qualitative data was transcribed and analysed using reflexive thematic analysis.

Results

The number of participants was eight in total. A main theme of how the robot may either help or harm concerning medication safety within a pharmacy setting was identified. The six sub-themes found, according to pharmacists' views on robot counselling in community pharmacies, are context, digital competence, customer integrity, interaction, pharmacists' professional role and human skills.

Conclusions

According to the study findings, pharmacists experience that the social robot can offer a potential complement to a human pharmacist. The robot is seen as beneficial with respect to certain customer groups and in the light of personnel shortages, and may in the future add to trust, equality, freedom of choice and multilingualism, among other things, in the customer service situation at community pharmacies, thus improving medication safety.

Health as a movement between suffering of life and meaning in life for men who have experienced transitions in life

BACKGROUND AND AIM

Previous studies show that life transitions can have negative effects on men's lives and lead to health problems and meaninglessness in life. This study aims to deepen the understanding of men's health by exploring the movement between suffering of life and meaning in life when experienced life transitions.

THEORETICAL FRAMEWORK

The study is anchored in Eriksson's caritative caring theory. Core concepts are health and the movement between suffering of life and meaning in life.

METHODOLOGY AND METHODS

The methodology is hermeneutical, and the study has a qualitative research design. Fifteen men from Norway participated in in-depth interviews in 2021. The interviews were analysed using reflexive thematic analysis.

RESULTS

Four themes emerged in relation to the suffering of life; enduring separation from community, shame at being useless as a human being, grief over what has been lost in life, and being powerless and vulnerable in the face of a hopeless struggle. Three themes emerged in relation to meaning in life; realising what is most important in one's life gives strength, decision to live one's life brings joy in life and a positive attitude towards life gives freedom and awakens a new spark for life.

CONCLUSION

Suffering of life emerges as a separation from relationships and society and as a perceived uselessness as a human being losing faith, control and feeling like a burden erodes dignity and trigger feelings of shame, guilt and degradation. Suffering of life manifests as loss of drive and spark for life. Life has meaning through finding the good in oneself, coming to know and believe in oneself and seeing new possibilities which bring about a spark for life, gratitude, dignity and freedom. Health exists in the movement between suffering of life and meaning in life, in pausing, recognising vulnerability, prioritising and reorienting oneself.

What is giving vitality to continue at work? A qualitative study of older health professionals' vitality sources

BACKGROUND AND AIM

Vitality is described as 'life energy', 'inner strength' and 'inner health resource' and is the essence of health. Especially during the ageing process, it is of fundamental importance that an individual's health resources are strengthened to support work ability. The need for health services increases as the population ages and meanwhile the workforce in health care is also ageing. The aim of the study was to explore what is giving vitality to older workers in health care to continue at work until retirement age and maybe even an extended working life.

INFORMANTS, METHODOLOGY AND METHODS

A qualitative interview study was conducted. A total of 15 people aged 59-65 participated in the study, all of them working in the health care sector. Five participants were administrative personnel and ten were nurses. One man and fourteen women took part in the study. Qualitative content analyses were used.

FINDINGS

The results show that meaningful work, possibilities to use one's knowledge, relationships and work community are promoting vitality. Vitality is affected by work conditions, benefits, personal values and own health.

CONCLUSION

Plans about continuing at work seem to depend on both external and internal reasons. Knowledge of what influences older employees' vitality resources makes it possible to improve their work situation so that vitality and work ability can be maintained by occupational health and employers despite the ageing process.

Users' ambivalent sense of security with humanoid robots in healthcare

Humanoid robots have already been shown to be useful in healthcare. To ensure successful interactions with humanoid robots, is it essential that the factors that influence users' sense of security be understood. Ensuring patients' sense of security is considered a key principle of good caring. The aim of this study was to illuminate users' sense of security with humanoid robots in healthcare. Twelve semi-structured interviews were conducted. The participants consisted of five women and seven men aged 24-77. Before being interviewed, the participants were shown a video vignette with Pepper, a fully developed humanoid robot, used in the daily care of patients. The data material was analyzed using qualitative content analysis. Most participants perceived the use of humanoid robots in healthcare to be both positive and negative. The overarching theme was: Ambivalent sense of security with humanoid robots in healthcare. The four categories revealed were: Humanoid robots are both reliable and unreliable, Humanoid robots are both safe and unsafe, Humanoid robots are both likable and scary, and Humanoid robots are both caring and uncaring. Here we increased knowledge of whether patients perceive a sense of security with humanoid robots in healthcare, including which fears users have. This is vital information that should be taken into consideration when further developing and introducing humanoid robots into the healthcare setting.

Humanoid robots in the care of older persons: A scoping review

The aim was to examine how humanoid robots have been used in the care of older persons and identify possible benefits and challenges associated with such use from older persons' points of view. The study was a scoping review based on Arksey and O'Malley's methodological framework. To identify peer-reviewed and non-peer-reviewed literature, a systematic search of the PubMed, Cinahl and Google Scholar electronic databases was conducted for studies published between 2013 and 2019. The PRISMA-ScR guidelines have served as a guideline. A total of 12 studies were included and resulted in four main categories related to how humanoid robots have been used in care of older persons (domain of use): Supports everyday life, Provides interaction, Facilitates cognitive training and Facilitates physical training. Potential for humanoid robots to be accepted as companions for older persons was seen, but technical issues, such as humanoid robots' slow response time or errors, emerged as key challenges. Older persons' perceived enjoyment of using a humanoid robot might also decrease over time. Validated measurements to estimate the effectiveness of using humanoid robots in the care of older persons are needed.

The core of Katie Eriksson's caritative caring theory - a qualitative study from a postdoctoral perspective

BACKGROUND

For about 40 years, Katie Eriksson developed the caritative caring theory at Åbo Akademi University in Finland. However, a description regarding the most substantial concepts and the relationships between these is lacking and thus needs to be explored.

AIMS

The aim of the study was twofold: to explore and describe central concepts in the development of caritative caring theory from a postdoctoral perspective and to uncover and explore the relationships between the concepts.

METHODOLOGY

The design of the study was qualitative with a mixed method approach. The material was collected from a postdoctoral group (n = 38) mainly through electronic questionnaires. The texts were interpreted through manifest and latent content analysis.

FINDINGS

The analyses generated five main categories including subcategories. The main categories were 'Caring' 'Ethos', 'Suffering' 'Health' and 'The human being'. The relation between the main concepts compiled as 'A tentative synthesis of the main concepts and the relationships between them'.

CONCLUSION

This study contributes to an understanding of the most fundamental and valuable concepts in the development of caritative theory during its first 40 years according to postdoctoral researchers' perspectives. This study also displays that the concepts ethos and caring have the strongest relationship followed by that between caring and health, indicating the inner core of ethos and love within caring which bears the potential of enhancing the patient's well-being and health.

The movement of virtue from ethos to action

In this paper, we explore the concept of virtue in nursing care. We particularly examine the description of 'virtue' offered by Aristotle, who considers it the mental constitution that forms the basis for laudable social behaviour. We then turn to Katie Eriksson's work on caritative caring ethics and draw parallels between the Aristotelian concept of virtue and being a good nurse. Eriksson suggests that embracing an ethos, a set of basic values, affects nurses' attitudes as well as the way they speak and take on their responsibility for the patient. We discuss these ideas in relation to a tentative ideal model of the movement from ethos to action to understand and address nurses' ethical thinking and acting. Here, we focus on the catalytic role of virtue as a means for realizing a deliberate, intentional acting with the best of the patient in mind. As an outcome of our analysis, we suggest that the movement of virtue from ethos to action is most usefully conceptualized as knowledge about facts, habits of the heart, deeds of the hand and the power of words. Implications for nursing leadership are suggested, including incorporating organizational values through the means of ethical conversations.

Workplace interventions that support older employees' health and work ability - a scoping review

Background

The aim of this study was to examine workplace interventions that support older employees’ health and work ability and the effect of these interventions.

Methods

We used a scoping review, a type of a systematic literature review in which selected published academic articles and grey literature reports are included, to answer the following questions: 1) What kind of interventions have been made to support older employees’ health? and 2) What effects do these interventions have on older employees’ work ability? The scoping review framework proposed by Arksey and O’Malley and summarized by the Joanna Briggs Institute was used. Four key concepts comprised the basis for the research: health, intervention, older employee and work ability. A total of 8 articles were found to meet the inclusion and exclusion criteria. The study was limited to published academic articles between 2007 and 2019. Participant age varied between 37 and 74 years (overall average age 50–55) and workplaces comprised the intervention settings.

Results

Three main intervention categories were discerned: health checks and counselling for employees on the individual level, interventions based on screenings, and improvements in work environment or organization. Positive behavioral change and lowered health risks can be achieved through health counselling, which increases work ability. Measurements and screenings comprise good ways to chart and follow-up on employees’ work ability and health status. Supervisor training and support from supervisors were seen to have a positive effect on health outcomes and increased work ability.

Conclusions

To guarantee good results, employers should focus on employees’ health and interventions should occur when employees are younger than the studied group. The small number of articles related to intervention studies for the age group studied here indicate that a knowledge gap exists. We maintain that workplaces that promote employees’ health by strengthening older employees’ vitality can encourage employees to have longer careers.

Mental well-being among the oldest old: revisiting the model of healthy ageing in a Finnish context

Purpose: This study aimed to examine how participants aged 80 years old or over describe their mental well-being—exploring the suitability of the model of healthy ageing when outlining the mental well-being concept.

Methods: Six structured focus group interviews with 28 participants were conducted in Western Finland in 2017. Qualitative content analysis was performed, where both manifest and latent content was considered in a process involving meaning condensation and coding, followed by categorization.

Results: The healthy ageing model constituted a useful framework for the conceptualization of mental well-being, illustrating the links between these two constructs. The analysis resulted in a four-dimensional model of mental well-being in oldest old age, the key components being: Activities—enjoyment and fulfilment; Capability—functioning and independence; Orientation—awareness, shifted perspectives and values; and Connectedness—sense of belonging.

Conclusions: Although functional status plays an important role for well-being in general, it is not the principal component of self-reported mental well-being within the heterogeneous group of the oldest old. Further, many persons in this age group do not view themselves as passive or dependent, on the contrary, they underline the importance of empowering attitudes, a positive mindset and actively creating circumstances which support their mental well-being.

A caring science study of creative writing and human becoming

The previous research describes creative writing to have a potential for self-care and healing in relation to illness and mental health conditions. The aim of this article was to deepen the understanding of creative writing and human becoming, from a caring science perspective. A data material consisting of answers from an e-form and diaries was analysed with a thematic analysis. The result depicts two main themes and seven subthemes. The first main theme, Creative writing - an act of emotional reactions and release, shows that creative writing is an act where fears and emotional reactions are unveiled; it is a relieving valve for the writer and includes moments of liberating wordplay. The second main theme, Creative writing - a key to self-understanding and personal growth, shows that creative writing is a genuine conveying of oneself to others, to experience mercifulness within oneself, to keep up faith in oneself and hope for the future and to find a new order of values. Creative writing enhances human becoming and gives possibilities for human beings to find inner peace and balance in life.

Application in the World of Understanding: Researchers' Experiences of Participation in Reflective Dialogues

The aim of this study was to describe researchers’ experiences of participation in reflective dialogues through a hermeneutic application research approach. The aim was also to describe their perspectives on application, that is, the inner appropriation and application of theory into practice and vice versa. Twenty-one clinical coresearchers and four scientific researchers participated in reflective dialogues in a project on ethical sustainable caring cultures, in which an application research approach was used. The study included questionnaires, a focus group interview, and conversations. The findings show that participation in the reflective dialogues required that the participants are present, open for dialogue, share a common interest in the thematics of the dialogue, and are given space to express themselves. The participants described their experiences of the dual meaning underlying application. Application research strengthened the relationship between research and clinical practice and it contributed to the development of theory.

Toward Understanding Through Hermeneutic Letterwriting

The authors present letterwriting as a hermeneutic research method in that it contributes to the methodological development within the hermeneutical research tradition in caring science. The hermeneutic methodology is inspired by Hans-Georg Gadamer. Hermeneutic letterwriting in accordance with Gadamer's thought is a form of dialogue in writing, where what is truthful about the thing itself is unveiled with the help of the language. Hermeneutic letterwriting is presented in five steps. As a method, hermeneutic letterwriting is appropriate for complex caring science issues, and it offers new opportunities for attaining a deeper understanding of the world of caring.

Sustainability in care through an ethical practice model

Background:

While sustainability is a key concept in many different domains today, it has not yet been sufficiently emphasized in the healthcare sector. Earlier research shows that ethical values and evidence-based care models create sustainability in care practice.

Objective:

The aim of this study was to gain further understanding of the ethical values central to the realization of sustainability in care and to create an ethical practice model whereby these basic values can be made perceptible and active in care practice.

Research design:

Part of the ongoing “Ethical Sustainable Caring Cultures” research project, a hermeneutical application research design was employed in this study.

Participants:

Dialogues were used, where scientific researchers and co-researchers were given the opportunity to reflect on ethical values in relation to sustainability in care.

Findings:

An ethical practice model with ethos as its core was created from the results of the dialogues. In the model, ethos is encircled by the ethical values central to sustainability: dignity, responsibility, respect, invitation, and vows.

Discussion:

The model can be used as a starting point for ethical conversations that support carers’ reflections on the ethical issues seen in day-to-day care work and the work community, allowing ethical values to become visible throughout the entire care culture.

Conclusion:

It is intended as a tool whereby carers can more deeply understand an organization’s common basic values and what they entail in regard to sustainability in care.

Life with an unwelcome guest - caring in a context of protracted bodily pain

Protracted bodily pain is a phenomenon that often affects a human being's whole life. Care of human beings with protracted pain is challenging because pain is not always measureable, and the experiences of pain are subjective, unique and shapeshifting. Therefore, the aim is to highlight what protracted bodily pain signifies for the human being, and human beings' experiences of what is caring in a context of protracted bodily pain. Four informants with protracted bodily pain took part in a focus group interview. The interview was analysed by using a qualitative content analysis with a hermeneutic approach. The findings show that protracted pain renders human beings speechless, limits and robs them of their lives. The pain is described as a domineering, unpleasant and unwelcome guest. The pain can change the human being's personality and creates feelings of guilt. Uncertainty about the origin of the pain as well as a nonchalant treatment or not being believed intensifies the pain. Human being experience mastering the pain, encounters with caregivers who can ease the burden, community with others and finding that little something extra in everyday life is experienced as caring. From a caring science perspective, the relation between protracted pain and suffering is obvious. Suffering emerges as illness suffering, as life suffering and as suffering caused by care. Professional as well as natural caring is important in a context of protracted bodily pain. The human being longs to encounter caregivers who are courageous enough to lay themselves on the line. Community with people who are prepared to share the burden eases the heavy burden that pain brings to life, it brings hope and relief.

Understanding and safeguarding patient dignity in intensive care

Background:

Dignity has been highlighted in previous research as one of the most important ethical concerns in nursing care. According to Eriksson, dignified caring is related to treating the patient as a unique human being and respecting human value. Intensive care unit patients are vulnerable to threatened dignity, and maintaining dignity may be challenging as a consequence of critical illness.

Objectives:

The aim is to highlight how nurses in an intensive care setting understand patient dignity, what threatens patient dignity and how nurses can safeguard patient dignity.

Research design and participants:

Data materials were collected through a survey questionnaire which contained open questions about patient dignity, and the text was analysed using hermeneutic reading and text interpretation. Totally, 25 nurses employed in an intensive care unit in Finland participated in the study.

Ethical considerations:

The study follows the guidelines for good scientific practice by the Finnish Advisory Board on Research Integrity and the ethical principles according to the Declaration of Helsinki.

Findings:

Findings revealed that nurses recognize the patients’ absolute dignity by regarding them as unique human beings. The nurses also recognize the importance of shared humanity in preserving patient dignity. Intensive care patients’ dignity is threatened by negative attitudes and when their integrity is not being protected. Dignity is also threatened when patients and nurses are not part of the patients’ care and patient care decisions, when patients receive care against their will and because of the acute nature of intensive care.

Determination of selenium in freshwaters by cathodic stripping voltammetry after UV irradiation

An analytical method was developed for the determination of total dissolved selenium in fresh waters, using linear sweep cathodic stripping voltammetry (CSV) in combination with UV photolytic digestion. Both the CSV method, based on the electrodeposition and stripping of Cu(2)Se, and the UV irradiation procedure were investigated in detail. In the presence of dissolved organic substances, as in freshwaters, Se(VI) is reduced to Se(IV) by UV irradiation in 0.1M hydrochloric acid. Glucose can be used as the carbon source in samples low in natural dissolved organic carbon (DOC). The photolytic yields of Se(IV) were about 90% in both cases. Five freshwater samples were analysed for total selenium by CSV after UV photolysis, and by hydride generation atomic absorption spectrometry (HG-AAS) after oxidative digestion followed by reduction with hydrochloric acid. The results agreed well and the concentrations were in the range 70-190 ng/l., well above the detection limit of the CSV method at 2 ng/l.

Evaluations of the stability of sheathless electrospray ionization mass spectrometry emitters using electrochemical techniques

The processes that cause the failure of sheathless electrospray ionization (ESI) emitters, based on different kinds of gold coatings on fused-silica capillaries, are described and explained. The methods chosen for this study include electrochemical methods, ICPMS analysis of the electrolytes used, SEM studies, and electrospray experiments. Generally, the failure occurs by loss of the conductive coating. It is shown that emitters with sputter-coated gold lose their coatings because of mechanical stress caused by the gas evolution accompanying water oxidation or reduction. Emitters with gold coatings on top of adhesion layers of chromium and nickel alloy withstand this mechanical stress and have excellent durability when operating as cathodes. When operating as anodes, the adhesion layer is electrochemically dissolved through the gold film, and the gold film then flakes off. It is shown that the conductive coating behaves as a cathode even in the positive electrospray mode when the magnitude of a superimposed reductive electrophoretic current exceeds that of the oxidative electrospray current. Fairy-dust coatings developed in our laboratory (see Barnidge, D. R.; etal.Anal. Chem. 1999, 71, 4115-4118,) bygluing gold dust onto the emitter, are unaffected by the mechanical stress due to gas evolution. When oxidized, the fairy-dust coatings show an increased surface roughness and decreased conductivities due to the formation of gold oxide. The resistance of this oxide layer is however negligible in comparison with that of the gas phase in ESI. Furthermore, since no flaking and only negligible electrochemical etching of gold was found, practically unlimited emitter lifetimes may be achieved with fairy-dust coatings.

Elimination of high-voltage field effects in end column electrochemical detection in capillary electrophoresis by use of on-chip microband electrodes

The influence of the separation voltage on end column electrochemical detection (EC) in capillary electrophoresis (CE) has been investigated using an electrochemical detector chip based on an array of microband electrodes. It is shown, both theoretically and experimentally, that the effect of the CE electric field on the detection can be practically eliminated, without using a decoupler, by positioning the reference electrode sufficiently close to the working electrode. In the present study, this was demonstrated by using an experimental setup in which neighboring microband electrodes on a chip, positioned 30 microns from the end of the CE capillary, were used as working and reference electrodes, respectively. The short distance (i.e., 10 microns) between the working and reference electrode ensured that both of the electrodes were very similarly affected by the presence of the CE electric field. With this experimental setup, no significant influence of the CE voltage on the peak potentials for gold oxide reduction could be seen for CE voltages up to +30 kV. The detector noise level was also found to be reduced.

A simple and robust conductive graphite coating for sheathless electrospray emitters used in capillary electrophoresis/mass spectrometry

A graphite-polyimide mixture was used as a conductive coating for sheathless electrospray emitters. The coating procedure described is simple and inexpensive compared to previously described methods. An investigation of the stability of the conductive coating carried out by electrochemical methods revealed good performances during oxidative stress. In addition, no decrease in emitter performance was seen during continuous electrospray in the positive electrospray mode for two weeks. Fast capillary electrophoresis with attomole sensitivity demonstrated the excellent performance of the described sheathless interface when used in conjunction with an orthogonal time-of-flight mass spectrometer. The overall simplicity, stability and low cost of this type of sheathless emitter make the described approach highly suitable for any on-column coupling of low flow rate separation techniques to a mass spectrometer.

Characterization of the atmospheric pressure ionization mass spectrometric process obtained using a fused-silica emitter with the high voltage applied upstream

The atmospheric pressure ionization process obtained when a mixture of methanol and water (90:10, v/v) also containing 50 microM sodium hydroxide is dispersed from a fused-silica emitter was studied. A combination of a high electric field and a nebulizer gas with the high voltage applied upstream in the liquid flow was utilized to facilitate the spray process. By comparing the dependences of the spray current and ion signals on the spray potential, it was found that electrical corona discharges were obtained for potentials higher than about 2.6 kV, which resulted in a mixed electrospray and chemical ionization process. By introducing vapour from a solvent, such as benzene or toluene, with a low ionization energy into the nebulizing gas, it was found that the appearance of the corresponding molecular ion was correlated with a change in the slope of the spray current-potential curve. This indicates that the breakpoints in the spray current-potential curves observed were correlated with the onsets of corona discharges. It was shown that the mixed ionization process gives rise to increased amounts of protonated solvent molecules and assists in the formation of sodiated adduct ions from an uncharged fatty acid methyl ester.

Benchmarking: a case report

In mid 1993, administrators and physicians at Bristol Medical Center teams up with HCIA to perform clinical pathway analysis on five diagnosis related groups. The major goal of this project was to establish a partnership between the hospital administration and the medical staff to meet or beat existing benchmarks.

Immunochemical partial identity between two independently identified and isolated major allergens from Alternaria alternata (Alt-I and Ag 1)

Partially purified preparations of Alt-I, the main allergenic fraction of Alternaria alternata isolated by Yunginger, and of Ag 1, shown in crossed radioimmunoelectrophoresis (CRIE) to be the dominating major allergen of A. alternata (Løwenstein, Nyholm), were compared by tandem crossed immunoelectrophoresis (CIE), RAST inhibition, and the CRIE-related technique, single radial radioimmunodiffusion (SRRID). The two allergen preparations showed reaction of identity in tandem-CIE and indistinguishable specific IgE binding in CRIE and SRRID, regardless of antibodies and serum pools used. In RAST inhibition, the relative potencies of the allergen preparations and of the crude extracts correlated well with their Alt-I/Ag 1 content as estimated by rocket immunoelectrophoresis. Moreover, all inhibition curves were parallel, confirming identical IgE binding by Alt-I and Ag 1 with the serum pools used. A second preparation of Alt-I, isolated from another strain of Alternaria, showed reaction of partial identity with Ag 1 in tandem-CIE, indicating that different variants of Alt-I (Ag 1) may exist in different strains of A. alternata.