The phenomenological approach in dentistry - a narrative review

PURPOSE

Phenomenology is a branch of philosophy that focuses on human lived experience. Illness including dental diseases can affect this living experience. Within the dental literature, there is very little reported on the use of phenomenology compared to other healthcare sciences. Hence, the aim was to review the literature and provide an overview of various applications of phenomenology in dental research.

METHODS

This study was a narrative review using literature in the last 10 years identified by web-based search on PubMed and Scopus using keywords. A total of 33 articles that were closely related to the field and application in dentistry were included. The methodology, main results, and future research recommendations, if applicable, were extracted and reviewed.

RESULTS

The authors in this study had identified several areas such as orofacial pain and pain control research, dental anxiety, dental education, oral healthcare perceptions and access, living with dental diseases and dental treatment experience in which the phenomenological method was used to gain an in-depth understanding of the topic.

CONCLUSIONS

There are several advantages of using the phenomenological research method, such as the small sample size needed, the diverse and unique perspective that can be obtained and the ability to improve current understanding, especially from the first-person perspective.

Dysphoria as trans-diagnostic mood symptom and as lived experience. Lessons from prose, poetry and philosophy

This paper attempts to provide a characterisation of it from a first-person perspective of dysphoria, answering the question 'how it feels like to be dysphoric?'. Starting with a definition of emotions as embodied phenomena that provide the person with a felt motivation to move, a rich characterisation of dysphoria is provided centred on the coenesthetic and kinesthetic feelings inherent to this emotion. To fulfil this task, a selected choice of literary, poetic, theatrical and philosophical texts is used to compensate for the quasi-ineffability of the contrasting feelings inherent to dysphoria. Current definitions of dysphoria only highlight the 'negative' side of dysphoria, including irritability, discontent, surrender and interpersonal resentment. A more accurate characterisation necessitates the recognition of the 'positive' side of dysphoria and the ambiguities and contradictions inherent in this emotion. Dysphoric persons feel burdened by a weight that prevents them from moving and simultaneously incites movement. The inertia that accompanies dysphoria is inextricably tied in with a vital urge, however disordered and purposeless. Dysphoria is experienced both as a deadly stagnation and as a chaotic, wild impulse that brings with it an inane aspiration to explore the darkest parts of one's self in search of a glimmer of meaning and authenticity. This characterisation of dysphoria can help to differentiate it from other emotions such as sadness, anger, anxiety and anguish, and thus to identify it more precisely within the spectrum of mood disorders.

The lived experiences of operating room nurses from the surgery on COVID-19 patients: a phenomenological study

BACKGROUND

During the COVID-19 pandemic, some patients who were transported to the operating room for emergency surgery had COVID-19; operating room nurses should be in direct contact with these patients in a small and closed space of the operating room. This can lead to unpleasant experiences for these people. Accordingly, this study was conducted to understand the experience of operating room nurses during the surgery of COVID-19 patients.

METHODS

This qualitative study is a descriptive phenomenological study. Sampling was done purposefully and participants were selected based on the inclusion and exclusion criteria. The data of this study was obtained through semi-structured interviews with 12 participants and analyzed using the Colaizzi method.

RESULTS

Four main themes and 13 sub-themes were presented in this study: (1) feeling heroic (being a savior, self-sacrificing). (2) Exacerbating burnout (emotional exhaustion, feeling of incompetence, physical overtiredness). (3) Psychiatric crisis (destructive anxiety, horror of death, worrying about being a carrier, drastic feeling of pity). (4) Feeling the need for support (need for professional support, need for emotional support, need for social support).

CONCLUSION

The results of this study show that operating room nurses experienced conflicting feelings during surgery on patients with COVID-19. So the feeling of being a hero was a heartwarming experience, but the aggravation of job burnout and mental crisis was unpleasant for them. Also, these people have experienced the need to be supported in various aspects.

Mindfulness, Phenomenology, and Psychological Science

Most present-day research on mindfulness treats mindfulness as a variable that is studied in relation to other variables. Although this research may provide us with important knowledge at the population level and mechanism level, it contributes little to our understanding of the phenomenon of mindfulness as it is experienced and enacted at the person level. The present paper takes a person-oriented phenomenological perspective on mindfulness, comparing this perspective with that of von Fircks' (2023). In a first part of the paper, mindfulness is discussed as a phenomenological practice that can be studied by means of experimental phenomenology. It is argued that there is room for the development of an immense variety of personalized mindfulness practices that may serve people's health and well-being. The second part of the paper contains a brief discussion of the possible role of mindful observation and reflection in psychological research. It is argued that mindfulness skills may be important both for improving the quality of phenomenological observation and to facilitate creative thinking in connection with the development of psychological theory. A main implication is that an integration between mindfulness and phenomenology may serve as an important part of this process.

The Loss of Spatiality and Temporality in Twilight Consciousness: The Emergence of Exogenous Psychosis Induced by Novel Psychoactive Substances

BACKGROUND

The state of twilight consciousness is marked by a focused narrowing of awareness, maintaining vigilance and attention while simultaneously experiencing perceptual shifts in the surrounding environment. It is crucial to recognize that this twilight state represents not just a contraction but also an expansion of conscious experience.

SUMMARY

Substances of abuse, particularly new psychoactive substances, play a significant role in inducing this twilight state. They achieve this by deconstructing essential components of consciousness, such as the perception of time and space.

KEY MESSAGE

This paper aimed to explore the phenomenon of the twilight state of consciousness and shed light on how new psychoactive substances can alter the perception of time and space during this twilight phase, potentially triggering exogenous psychosis. This comprehensive inquiry employs a phenomenological approach to the study of consciousness, recognizing it as the primary tool for ascribing significance to this intricate yet often overlooked aspect of psychopathology.

An examination of the potential core symptoms of posttraumatic stress disorder: What is integral after removing general psychopathology & distress?

Many confirmatory factor analyses (CFA) have examined the structure of posttraumatic stress disorder (PTSD) with some suggesting increased complexity (i.e., 6+ factors), while others suggesting a more refined structure (i.e., 2-factors). These competing PTSD structures may be due to conflation of non-trauma specific symptoms that have been added overtime. However, none of these studies examined if all symptoms being examined are specific to PTSD or potentially more related to general distress and psychopathology. The current study re-evaluated the structure of PTSD using bifactor exploratory factor analysis (EFA) to identify the construct's core symptoms. Data for EFA models were taken from a sample of Veterans (N = 694) attending outpatient therapy for PTSD and were cross-validated using CFA in a sample of 297 Veterans attending residential treatment. Clinician Administered PTSD Scale for DSM-5 (CAPS-5) at pre-treatment was used across sample. Factor analyses resulted in a 2-factor, bifactor model comprised of eight total items. Model fit was robust, RMSEA = 0 [0.000, 0.036]; robust CFI = 1; robust TLI = 1.017. The bifactor analytic approach captured what might be the core structure of PTSD, which were pathognomonic symptoms of PTSD (Factor one). A distinct second factor related to depression was also found. In identifying this structure, the model eliminates redundancies and lesser performing items and differentiates depressive reactions as potentially distinct and separate. Overall, these findings may assist in future research of PTSD by determining the unique elements of the construct within a veteran sample versus associated features, general psychological distress, and comorbid psychopathology.

In Pursuit of credibility: Evaluating the divergence between member-checking and hermeneutic phenomenology

Credibility refers to the trustworthiness, genuineness, and plausibility of the research findings and has always been a contentious issue in qualitative research, particularly for those conducting studies on the hermeneutic phenomenology paradigm. The relationship between credibility and high qualitative research is noted by many qualitative scholars. Member checking, also known as participant or respondent validation, is a technique for exploring the credibility of results where data or results are returned to participants to check for accuracy and resonance with their experiences. Although member-checking has long been accepted as the gold standard in quantitative research, research shows that it is not the pinnacle for expressing rigor in Heideggerian hermeneutic phenomenology because it contradicts many of the underpinning philosophies. Within this article the author explores how member checking has been used in published research and presents a brief overview of the various discourses on member checking in qualitative research. The author discusses the importance of evaluating whether the method fits with the theoretical position of a study and the importance to consider how member checking was undertaken and for what purpose. It is essential that researchers are transparent about what they hope to achieve with the method and how their claims about credibility and validity fit with their epistemological stance.

Exploring sedentary behavior during neo- or adjuvant treatment in patients with cancer: A phenomenological study

PURPOSE

Increased sedentary behavior during cancer treatment is common, which may have negative long-term health effects. Understanding patients' experience of sedentary behavior during neo- or adjuvant cancer treatment may be crucial in developing effective support for patients to reduce sedentary behavior. Therefore, the present study aimed to explore sedentary behavior in patients undergoing neo- or adjuvant cancer treatment.

METHODS

Eleven interviews were conducted with patients undergoing treatment for breast, prostate, and colorectal cancer. Participants were recruited from a university hospital in Sweden. Interviews were analyzed phenomenologically, and the results were presented as descriptions of the phenomenon sedentary behavior.

RESULTS

The overarching theme of sedentary behavior during cancer treatment was that sedentary behavior is experienced through being physically active or not. Furthermore, experiences of sedentary behavior increased with side effects and varied depending on the type and phase of cancer treatment, meaning that sedentary behavior is an adjustment to side effects. Additionally, sedentary behavior was influenced by life circumstances and social interaction, such as work status and having social support. Finally, sedentary behavior is influenced by strategies and motivations, such as the perceived benefits of physical activity and self-image.

CONCLUSIONS

Sedentary behavior is difficult for patients to discern, which is why health care personnel may need to help patients by increasing awareness of the negative impact of sedentary behavior in a way that does not stigmatize patients. Furthermore, developing support that targets periods with more side effects and helping patients reduce sedentary behavior throughout changing life circumstances may be helpful.

Embodiment and regenerative implants: a proposal for entanglement

Regenerative Medicine promises to develop treatments to regrow healthy tissues and cure the physical body. One of the emerging developments within this field is regenerative implants, such as jawbone or heart valve implants, that can be broken down by the body and are gradually replaced with living tissue. Yet challenges for embodiment are to be expected, given that the implants are designed to integrate deeply into the tissue of the living body, so that implant and body become one. In this paper, we explore how regenerative implants may affect the embodied experience of implant recipients. To this end, we take a phenomenological approach. First, we explore what insights the existing phenomenological and empirical literature on embodiment offers regarding the experience of illness and of living with regular (non-regenerative) implants and organ transplants. Second, we apply these insights to better understand how future implant recipients might experience living with regenerative implants. Third, we conclude that concepts and considerations from the existing phenomenological literature do not sufficiently address what it might be like to live with an implantable technology that, over time, becomes one with the living body. We argue that the interwovenness and intimate relationship of people living with regenerative implants should be understood in terms of 'entanglement'. Entanglement allows us to explore the complexities of human-technology relations, acknowledging the inseparability of humans and implantable technologies. Our theoretical foundations regarding the role of embodiment may be tested empirically once more people will be living with regenerative implants.

Breast cancer survivors suffering from lymphedema: What really do affect to corporeality/body image? A qualitative study

Breast cancer-related lymphedema is currently one of the most serious complications that most affect the quality of life of women undergoing breast cancer. The aim of this study was to explore in-depth the experience of women who suffer from lymphoedema after breast cancer and how does this condition affect corporeality, with no judgements. For this purpose, a qualitative methodology was followed. In-depth interviews, interviewer's field notes and participants' letters were used for data collection. The participants were twenty Spanish women with lymphoedema after overcome a breast cancer in the past. Healthcare specialists with experience in the topic were also included. Results showed 2 main categories: "From cancer to lymphedema, another disease another disease" and "Potential for transition and transformation towards a new way of life". As a conclusion, the difficulty in accessing adequate treatment, the need for greater awareness of lymphedema and the importance of the emotional and psychological dimension of this chronic disease. Highlighting the attitudes that these women develop for self-care and the concept of new corporeality. After breast cancer, women with lymphedema experience a drastic change that affects all areas of their lives. The adaptation process, and the search for resources and aid, play a fundamental role in overcoming this process.

Facing the Unknown: An Inductive Analysis of the Lived Experience of Medical Residents during the COVID-19 Pandemic

INTRODUCTION

The COVID-19 pandemic had significant repercussions for the everyday life and public health of society. Healthcare professionals were particularly vulnerable. Here, we interviewed medical residents about their lived experiences during the pandemic to offer a phenomenological analysis. To this end, we discuss their pandemic experiences considering Jaspers' "limit situation" concept - that is, a radical shift from their everyday experiences, to one causing them to question the basis of their very existence.

METHODS

We interviewed 33 medical residents from psychiatry and other specialties from the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP) who either (a) worked directly with COVID-19 patients or (b) provided psychiatric care to other healthcare professionals. Semi-structured interviews were developed using the Inductive Process to Analyze the Structure of lived Experience (IPSE).

RESULTS

The descriptions of the lived experiences of medical residents during the pandemic were organized into four content themes: (a) existential defense, (b) limit situations during the COVID-19 pandemic, (c) changes in lived experience, and (d) new world meanings through lived experience.

CONCLUSION

During the COVID-19 pandemic, medical residents experienced what can be thought of as a "limit situation," as they encountered the healthcare delivery challenges coupled with the social isolation imposed by the COVID-19 pandemic. These challenges included fear of infection and potential death, uncertainty about the future, and the emotional overload caused by the sharp increase in patient deaths. That said, after facing such a limit situation, residents reported feeling strengthened by this experience. This is consistent with the notion that when confronted with limit situations, we draw on our resources to overcome adversity and, in turn, reap existential gains. Health care providers might use these experiences to energize their own professional approach.

The perceived experience of adhering to vegan diet: a descriptive phenomenological study

BACKGROUND

Today, raw vegetarianism is considered one of the most important socio-cultural developments in contemporary societies. In this regard, the present study was conducted to describe the perceived experience of people adhering to a vegan diet through a phenomenological perspective.

METHODS

This qualitative study explores the perceived experiences of individuals who follow a vegan diet and are part of the self-care campaign in Kermanshah, Iran. sampling was purposeful and face-to-face interviews were conducted with 12 individuals who follow a vegan lifestyle. The data were analyzed after being collected using the seven steps of Collizi. MAXQUDA software (version 12) was used for data management.

RESULTS

After qualitative data analysis, we identified 567 codes, which were categorized into 15 sub-themes. From these sub-themes, we derived 4 main themes. The main themes include: In pursuit of redemption (Meaningful framework, In awareness path, Unequaled Disappointment, Chronic and complex conditions), Seeking the New World (Starting with doubt and hesitation, The temptation to return, Constant criticism, Unfamiliar appearance), On the path of overcoming difficulties (Associate problems, Matching the new way, Perceived recommendations), and attaining the expected outcomes (Healthy lifestyle, Therapeutic feedback, Enhancing emotional wellbeing, Feeling of youth).

CONCLUSION

Based on the participants' experience, despite the challenging journey, the people with a vegetarian diet experienced partial and complete improvement of all the symptoms of the diseases. They had a healthy lifestyle and felt young and energetic. Likewise, this method had a positive effect on people's mental state and mood.

Phenomenology of auditory verbal hallucination in schizophrenia: An erroneous perception or something else?

This study presents phenomenological features of auditory verbal hallucinations (AVH) in schizophrenia and associated anomalies of experience. The purpose is to compare the lived experience of AVH to the official definition of hallucinations as a perception without object. Furthermore, we wish to explore the clinical and research implication of the phenomenological approach to AVH. Our exposition is based on classic texts on AVH, recent phenomenological studies and our clinical experience. AVH differ on several dimensions from ordinary perception. Only a minority of schizophrenia patients experiences AVH localized externally. Thus, the official definition of hallucinations does not fit the AVH in schizophrenia. AVH are associated with several anomalies of subjective experiences (self-disorders) and the AVH must be considered as a product of self-fragmentation. We discuss the implications with respect to the definition of hallucination, clinical interview, conceptualization of a psychotic state and potential target of pathogenetic research.

Insisting on help, facing challenges, and maintaining balance: The lived experiences of caregivers raising a child with developmental delay in the remote islands of Kinmen

PURPOSE

To explore the lived experiences of the caregivers of children with developmental delay (DD) on the remote island of Kinmen, Taiwan.

DESIGN AND METHODS

This descriptive phenomenological study included 14 caregivers of 16 children with DD recruited from Kinmen, Taiwan. Data were collected from September 2020 to February 2021 with face-to-face semi-structured interviews, which were transcribed verbatim and analyzed using thematic analysis.

RESULTS

Twelve caregivers were mothers; there was one father and one grandmother. Their mean age was 37.93 ± 5.17 years. The mean age of the children was 3.90 ± 1.49 years; 11 were male (69%). As we began our study, the COVID-19 pandemic occurred, which influenced two of the three themes: (1) focusing on their child's delayed development, which involved seeking a diagnosis and blaming themselves; (2) facing barriers to caring a child with DD on a remote island, which included ostracization of their child and limited off-island medical resources, especially during COVID-19; and (3) maintaining a healthy life balance, which involved protecting their child from physical or spiritual harm, including exposure to COVID-19, and reflecting on their strengths.

CONCLUSIONS

Our findings highlight the challenges of caring for a child with DD in the Kinmen islands of Taiwan, and the impact of the COVID-19 pandemic.

PRACTICAL IMPLICATIONS

Healthcare professionals are encouraged to provide caregivers of children with DD living in remote, island communities an opportunity to share their caregiving experiences and provide strategies for obtaining medical care, which could help reduce caregiver burden.

Clarifying and measuring the characteristics of experiences that involve a loss of self or a dissolution of its boundaries

Mystical experience, non-dual awareness, selflessness, self-transcendent experience, and ego-dissolution have become increasingly prominent constructs in meditation and psychedelic research. However, these constructs and their measures tend to be highly overlapping, imprecise, and poorly integrated with similar pathological experiences. The present study seeks to clarify the common factors involved in the characteristics of these experiences using precise distinctions across an array of experience contexts (including meditation, psychedelics, and psychopathology). Participants (N = 386) completed an online survey about an experience that involved either a dissolution of self-boundaries or a loss of selfhood. Confirmatory factor analyses resulted in 16 experience characteristics, including multiple types of changes in sense of self, co-occurring phenomenology, and cognitive and affective responses. Qualitative thematic analysis provided rich descriptions of experience characteristics. Taken together, results lead to a more specific measurement model and descriptive account of experiences involving a loss of self or self-boundary.

Introducing Cultural Psychology: An open Approach of Thinking

Cultural Psychology (CP) is a relatively young perspective, growing in the field of social sciences, nevertheless, its ideas are found throughout the fields and its ancestors' -Naturwissenschaften and Philosophy- history. CP has several central notions which are introduced in the following paper. Thru their introduction, the central goal of the revelation of the essence of the idea of CP is proffered. The core idea of CP is a general psychological concept that should be considered as a starting point from where new ideas, innovations and challenging theories can emerge. In other words, a new general psychological perspective we can use as a starting point.

Women's experiences with planned singleton upright breech birth - A phenomenological study

OBJECTIVE

To explore the experience of primi- and multiparous women with planned singleton upright breech births.

METHOD

We conducted face-to-face, in-depth interviews with five primiparous and five multiparous women who underwent a physiological breech birth at one hospital in Norway and analyzed the data using Giorgi's descriptive phenomenological method.

RESULTS

The phenomenon of women's experiences with physiological breech birth yielded four main constituents: "Mental preparedness and control", "The importance of shared decision-making and sufficient information", "Trust and the many 'faces' of birthing staff", and "'I actually did it!': Coping and control in the upright breech position". The significance of readiness, the influence of previous experiences and information, and the establishment of trust in midwives and gynecologists emerge as dominant themes. The sense of co-determination, control, and mastery is also highlighted.

CONCLUSIONS

Our findings underscore the pivotal role of personal attributes in fostering mental preparedness when confronted with unforeseen aspects of childbirth. Notably, women's experiences with upright breech birth vary; while some perceive it as an ideal birth, others find it more challenging. Factors such as unpreparedness, lack of information, diminished co-determination, and loss of control negatively impact birth experiences. This study's findings underscore the significance of tailoring maternity care to individual needs and improving information sharing. These measures are paramount for optimizing women's experience during upright breech births.

Embodied cognition and the imaging of bio-pathologies: the question of experiential primacy in detecting diagnostic phenomena

This article investigates the origins of the experiences involved in the diagnostics (detection and normative evaluation) of biological entities in image-based medical praxis. Our specific research aim presupposes a vast discussion regarding the origins of knowledge in general, but is narrowed down to the alternatives of anthropomorphism and biomorphism. Accordingly, in the subsequent chapters we will make an attempt to investigate and illustrate what holds the diagnostic experiential situation together-biological regularities, manifestation via movement, conscious synthesis, causal categories, or something else. We argue that as long as knowledge originates out of practices, a promising way forward is to oscillate between the prominent although controversial ideas of the history of philosophy and observations of concrete human practices, such as, in our chosen example, image-based medical diagnostics of biological pathologies. Although a number of thinkers are involved in the discussion, Aristotle and Husserl are most important here as the representatives of historical paradigms on the matter. The body in this research was not taken solely as the physical entity (Körper) but rather as a transcendental, constitutive structure where diagnostic and biological processes synchronize in teleological movement (Leib). However, philosophical speculations are illustrated by actual radiograms, the interpretation of which brings us back to the aforementioned question of primacy regarding cognition.

Meeting the needs of pregnant women in socially vulnerable situations: A phenomenological qualitative study

Objective

Vulnerability relates to fragile physical, psychological, and socio-environmental circumstances. Pregnant women's social vulnerability can lead to disruptions in their medical follow-ups, prematurity, and increased infant mortality rates, such that their special needs must be considered. Yet, despite different governments' 'perinatality' plans, international literature suggests their care can be improved. Although quantitative studies regularly evaluate these plans, few studies have assessed vulnerable pregnant women's views. This study explores the needs and expectations of vulnerable women regarding their follow-ups during pregnancy and identified strategies to improve their circumstances.

Methods

The study was a phenomenological qualitative study involving semi-structured interviews with women who gave birth in the past six months (December 2017 to June 2018) and who fulfilled at least one vulnerability criterion. The women were recruited by French midwives and general practitioners (GPs).

Findings

Concerning these vulnerable pregnant women, three phenomenological categories emerged: 1) they need to be monitored by a single trusted contact; 2) they seek medical and social support adapted to their situations that addresses their needs; and 3) they expect kind and person-centred communication skills from professionals who provide them appropriate information.

Conclusion

We identified various international recommendations to screen and care for vulnerable pregnant women, but still these women often experience numerous challenges. Finally, the implementation of recommendations for healthcare professionals based on women's real-life experiences could help optimise the identification of vulnerable pregnant women as well as their follow-up care.

Navigating the Path to Independent Dentist: A Qualitative Phenomenological Exploration

OBJECTIVE

The objective of this study was to explore the process of becoming an independent dentist, extending beyond the entry-level period.

MATERIALS AND METHODS

Fifteen general dental practitioners were interviewed. The recorded interviews were transcribed verbatim, and utilizing Colaizzi's descriptive phenomenological method, we sought to exclude subjectivity and derive meanings and themes from participants' experiences concerning the process of becoming independent dentists.

RESULTS

The study identified 3 phases in the process of developing as an independent dentist: (1) the foundation phase, involving dental training as a student under faculty supervision; (2) the extension phase, expanding experience as an entry-level dentist; (3) the equilibrium phase, characterized by providing stable dental care based on diverse experience and professionalism.

CONCLUSION

Becoming an independent dentist entails more than unsupervised treatment provision; it involves developing the professionalism necessary for delivering quality dental care through deliberate practice and reflection.

CLINICAL RELEVANCE

The study outlines the stages of transitioning to an independent dentist, spanning foundational training, entry-level experience, and achieving stable care provision. Emphasizing the importance of professionalism and reflection, it provides a valuable framework for enhancing dental education and on-going professional development, fostering both technical proficiency and a commitment to quality patient care.

The initial experiences of junior nursing college students when communicating with children during pediatric clinical practicum: A phenomenological study

PURPOSE

Nursing students feel stressed during pediatric clinical practicum due to limited communication encounters with hospitalized children. The purpose of this study was to describe junior nursing college students' experiences of communicating with children during pediatric clinical practicums.

DESIGN AND METHODS

A qualitative phenomenological research design was used. Purposive sampling was used to recruit 18 junior nursing college students who completed their pediatric clinical practicum. Data were collected using semi-structured interviews and were analyzed using Colaizzi's seven-step method for data analysis.

RESULTS

Three themes emerged from the data. (1) Difficulties in communicating during initial practicum: fear, rejection, self-doubt of communication abilities, and unfamiliarity with the application of communication techniques posed frustrations among nursing students. (2) Efforts to learn during practicum: self-empowerment, seeking a diverse support system, adjusting communication methods, and striving to establish good relationships allowed nursing students to adapt to the pediatric curriculum. (3) Effective communication at the later stages of practicum: mastering fundamental communication techniques and exercising pediatric therapeutic communication techniques allowed nursing students to feel accomplished.

CONCLUSIONS

Junior nursing college students initially encountered difficulties and frustration when communicating with children during their pediatric clinical practicum. This study serves as a guide for educators of pediatric nursing to design courses on communication with hospitalized children.

PRACTICE IMPLICATIONS

These findings could be used to develop foundation courses on communicating with children for first-time pediatric nursing practicum students; for example, formulating a course on therapeutic play for children that encompasses communication techniques, pediatric ward simulation, and introduction to therapeutic play.

Providing end of life care in the emergency department: A hermeneutic phenomenological study

BACKGROUND

Registered nurses report the experience of delivering end of life care in emergency departments as challenging. The study aim was to understand what it is like to be a registered nurse providing end of life care to an older person in the emergency department.

METHODS

A hermeneutic phenomenological study was conducted in 2021, using semi-structured interviews with seven registered nurses across two hospital emergency departments in Queensland, Australia. Thematic analysis of participants' narratives was undertaken.

FINDINGS

Seven registered nurses were interviewed; six of whom were women. Participant's experience working in the emergency department setting ranged from 2.5-20 years. Two themes were developed through analysis: (i) Presenting the patient as a dying person; and (ii) Mentalising death in the context of the emergency department.

CONCLUSIONS

Nurses providing end of life care in the emergency department draw upon their personal and aesthetic knowing to present the dying patient as a person. The way death is mentalised suggests the need to develop empirical knowing about ageing and supportive medical care and ethical knowing to assist with the transition from resuscitation to end of life care. Shared clinical reflection on death in the emergency department, facilitated by experts in ageing and end of life care is recommended.

Lived experiences of refugee women with vaginal fistula in Nakivale and Oruchinga refugee settlements, Isingiro District, Uganda

BACKGROUND

Vaginal fistula (VF) affects 2-3 million women globally, with the majority in Africa. In Uganda, it's 2%, with western Uganda having the highest prevalence. Major predisposing factors for refugee women include health system breakdowns and sexual violence during conflict. VF has severe consequences for women, relatives, and communities. There's limited information on lived experiences among refugee women with VF, and there's a need for quality prevention, treatment, and social reintegration strategies. This study aimed to understand the physical, psychosocial, and economic impacts of VF on refugee women in Nakivale and Oruchinga settlements and their coping mechanisms.

METHODS

Ten refugee women with VF were interviewed using qualitative study design, utilizing Social-Ecological and Transactional Models for data collection, analysis, and discussion.

RESULTS

Ten refugee women aged 24-50 years with or who had experienced VF participated in the study. They lived with VF for at least 2-15 years and had multiple stillbirths. Obstetric Fistula (OF) was the leading cause, followed by rape and cancer. Post-fistula, they faced social discrimination, emotional disturbances, survival difficulties, poverty, and lack of support. They struggled with stigma, social isolation, and marital sexual challenges.

CONCLUSION

Refugee women experience physical, emotional, financial, social, and sexual trauma due to VF. Discrimination and stigmatization from loved ones and society lead to isolation, depression, and suicidal thoughts. Despite successful repair, their social and emotional healing remains a burden for their lives. There is a need to provide a supportive environment for VF survivors.

Poststroke depression within the first year - phenomenology and clinical correlates from real-world data

BACKGROUND

Studies of poststroke depression (PSD) in Singapore are limited. Specifically, the dynamic epidemiology and phenomenology of PSD in the different stroke types are unknown.

OBJECTIVES

This study aims to characterize the epidemiology and phenomenology of PSD in both the hospital setting, and in the community setting up to one year after stroke.

METHODS

Real-world clinical data of 1732 consecutive stroke patients in a tertiary stroke centre was extracted from inception in January 2010 to 30 November 2021. The Hospital Anxiety and Depression Scale (HADS) and the Patient Health Questionnaire (PHQ) were used to identify PSD. Demographic, comorbidities and stroke-related variables, and stroke severity were extracted and analysed by stroke type - ischemic, haemorrhagic, and strategic, at the hospitalisation and community follow-up cross-sections. For each group, the characteristics of those with PSD were compared against those without PSD. Logistic regression was performed to identify PSD predictors. Phenomenology was mapped by the relative frequencies of endorsed items on PHQ and HADS in PSD patients.

RESULTS

The prevalence of in-hospital PSD was 19.24 % in ischemic stroke, and 24.59 % in both haemorrhagic strokes and strategic basal ganglia/thalamus strokes. Prevalence of PSD in 547 stroke patients who were followed-up ≤ 12 months was 6.42 % in ischemic strokes, 3.52 % in haemorrhagic strokes and 5.23 % among strategic strokes. The association of right sided, bilateral strokes, strategic strokes, and large vessel aetiology with PSD only exists for ischemic strokes. Greater functional impairment and a past psychiatric history are independent predictive factors of PSD in all stroke types. Symptom profile of in-hospital PSD includes anxious distress.

CONCLUSION

These findings have immediate clinical applicability considering the representativeness of the study sample.

Timelapse images datasets (2017-2022) from Livingston and Deception Islands, Antarctica, to study snow cover and weather conditions at the PERMATHERMAL monitoring network

In the Deception and Livingston Islands, South Shetland Islands, Antarctica, two sites belonging to the international Circumpolar Active Layer Monitoring (CALM) network were established in 2005 and 2009, respectively, as part of the PERMATHERMAL network. In 2017, part of the installed instrumentation was upgraded, incorporating new CC5MPX automatic photographic cameras from Campbell Scientific to acquire three daily photographs at 5Mpx in resolution, 2592 × 1984 pixels in size, and JPEG format. The photographs are taken during the central hours of the day (14, 15, and 16 h GMT) to ensure maximum brightness, even during the Antarctic winter. Powered by batteries and solar panels, two cameras were installed at each site with a panoramic view, devoid of vegetation except for small patches of moss. At each study point, the cameras are oriented in different directions, providing diverse angles of the study area, and allowing observation of various fields of view in the environment. The result is a dataset of images acquired in the 2017-2022 period, organized by site, year, and month, capturing environmental conditions and spatial distribution of the snow cover. This dataset, besides documenting the snow cover, allows assessment of meteorological conditions, prevailing wind directions in the area during snow events, even in more distant areas from the study point due to the configured field of view. In the case of the images from Livingston Island, it also enables the study of the Limnopolar Lake's fluctuating water level during spring and summer. For the images from Deception Island, it provides insight into the presence of pack ice in Foster Port, relevant for volcanic activity and the safety of numerous vessels entering the caldera of the active volcano.

Anomalies of imagination and development of psychosis: A phenomenological account

In 20th century psychiatry, various disturbances of imagination were discussed in the context of schizophrenia. Today, these notions have almost completely vanished from mainstream psychopathology. However, recent work has suggested that specific phenomena within this area have a relevance for differential diagnosis and early detection of psychosis. This paper first provides an overview of 20th century psychopathological literature, as well as more recent neurocognitive studies, addressing disturbances of imagination and their role for symptom formation in schizophrenia. It then discusses recent empirical investigations of subjective anomalies of imagination in schizophrenia-spectrum disorders and suggests a clinical-phenomenological account of their role in the development of psychotic symptoms. Empirically and conceptually, these subjective anomalies are linked with disturbances of basic self. Patients' descriptions of the development of their anomalous experiences and symptoms indicate that increased spatial (object-like) articulation and instability of the first-personal manifestation of imaginative experience can be involved in the emergence of delusions and hallucinatory phenomena. Finally, a potential link between subjective anomalies of imagination and the neurocognitive construct of source monitoring deficits is discussed.

Undergraduate nursing students' learning experiences using design thinking on a human development course: A phenomenological study

AIM

To explore nursing students' perceptions of their design thinking learning experiences on a human development course.

BACKGROUND

Design thinking is a person-centered analytic and creative learning process that promotes higher order thinking skills rather than knowledge retention alone. Currently, this is the first study that has investigated the use of the design thinking process for nursing students on a human development course.

DESIGN

A phenomenological research design.

METHODS

The participants were first-year nursing students enrolled on a human development course at a Taiwanese university. In-depth, semi-structured interviews were conducted in 2022 and sufficiently high information power was obtained after 15 participants were interviewed. Data were systematically analysed, summarized and decoded using Colaizzi's seven analysis steps.

RESULTS

Three themes and twelve subthemes emerged from the data. (1) Challenges experienced with the design thinking learning process: participants experienced anxiety because of the unfamiliar assignments, and they found the assignments to be thought-consuming, time-consuming and energy-consuming, plus the students needed to adapt to working in teams with classmates. (2) Adjustment strategies employed by participants: participants highlighted the importance of teamwork during the design thinking learning process. They achieved consensus through communication and sought support from others to overcome challenges related to design thinking; however, they ultimately needed to engage in problem-solving by themselves. (3) Developing the diversity of academic capabilities: after the human development course, participants experienced enriched mindsets, cognitive abilities, problem-solving skills, interpersonal relationships and knowledge application.

CONCLUSIONS

Design thinking provides creative teaching opportunities and encourages nursing students to engage in experimental and creative learning, which is a meaningful experience for them. Nurse educators could use the insights thus obtained to design a curriculum that sources design thinking as a learning process while facilitating the complexity and diversity of students' higher order thinking skills and not just repetitive learning.

Exploring the healthcare needs and experiences of pregnant women with congenital heart disease: A qualitative study

PROBLEM

Little is known regarding the healthcare needs and experiences of pregnant women with congenital heart disease (CHD) during pregnancy.

BACKGROUND

Congenital heart diseases are the most common birth anomalies, and they embrace a wide range of defects ranging from mild to complex and life-threatening defects. Pregnancy carries many physiological and psychological changes that affect pregnant woman with CHD and need special attention and consideration.

AIM

To explore the healthcare needs and experiences of Jordanian women with CHD during pregnancy.

METHODS

A descriptive phenomenological design was used. Utilising purposive sampling, 15 participants were recruited. Data was collected using individualised semi-structured interviews. Interviews were recorded and transcribed verbatim. Data were analyzed using Colaizzi's method.

FINDINGS

Three themes were identified: a) A broad spectrum of health needs during pregnancy, b) not being cared for, c) and the healthcare journey: Challenges and recommendations. Findings revealed that pregnancy in women with CHD is associated with many challenges and needs, and the lived healthcare experiences are mostly negative.

DISCUSSION

This study addresses the healthcare needs and experiences of pregnant women with CHD during pregnancy. Our findings shed light on healthcare needs explored hidden aspects of the experiences of this vulnerable population and gave them the chance to make their voices heard.

CONCLUSION

The study concluded that pregnant women with CHD experience hardship associated with negative challenges and personal suffering. The findings highlight the importance of the basic values and the need for a holistic approach and effective teamwork to minimise suffering among pregnant women with CHD.

What is it like to do a visuo-spatial working memory task: A qualitative phenomenological study of the visual span task

Working memory is typically measured with specifically designed psychological tasks. When evaluating the validity of working memory tasks, we commonly focus on the reliability of the outcome measurements. Only rarely do we focus on how participants experience these tasks. Accounting for lived experience of working memory task may help us better understand variability in working memory performance and conscious experience in general. We replicated recently established protocols for the phenomenological investigation of working memory using the visual span task. We collected subjective reports from eighteen healthy participants (10 women) aged 21 to 35 years. We observed that working memory can be phenomenologically characterized at three different time scales: background feelings, strategies, and tactics. On the level of tactics, we identified transmodality (i.e., how one modality of lived experience can be transformed into another one) as the central phenomenological dynamic at play during working memory task performance.

Unringing the bell: Successful debriefing following a rich false memory study

In rich false memory studies, familial informants often provide information to support researchers in planting vivid memories of events that never occurred. The goal of the current study was to assess how effectively we can retract these false memories via debriefing - i.e., to what extent can we put participants back the way we found them? We aimed to establish (1) what proportion of participants would retain a false memory or false belief following debriefing, and (2) whether richer, more detailed memories would be more difficult to retract. Participants (N = 123) completed a false memory implantation protocol as part of a replication of the "Lost in the Mall" study (Loftus & Pickrell, Psychiatric Annals, 25, 720-725, 1995). By the end of the protocol, 14% of participants self-reported a memory for the fabricated event, and a further 52% believed it had happened. Participants were then fully debriefed, and memory and belief for the false event were assessed again. In a follow-up assessment 3 days post-debriefing, the false memory rate had dropped to 6% and false belief rates also fell precipitously to 7%. Moreover, virtually all persistent false memories were found to be nonbelieved memories, where participants no longer accepted that the fabricated event had occurred. Richer, more detailed memories were more resistant to correction, but were still mostly retracted. This study provides evidence that participants can be "dehoaxed", and even very convincing false memories can be retracted.

Fostering dialogue: a phenomenological approach to bridging the gap between the "voice of medicine" and the "voice of the lifeworld"

This article adopts Husserl's transcendental phenomenology to explore the complex relationship between patients and physicians. It delves into the coexistence of two distinct voices in the realm of medicine and health: the "voice of medicine" and the "voice of life-world." Divided into three sections, the article emphasizes the importance of shifting from a scientific-medical attitude to a more personalistic approach in physician-patient interactions. This shift aims to prevent depersonalization and desubjectification. Additionally, it highlights the equal and irreducible nature of patients while acknowledging the vital role physicians hold in the realm of illness. The article stresses the need for a balanced and equitable relationship between both parties, rooted in the shared life-world. Moreover, empathy is underscored as a crucial element in fostering meaningful dialogue, wherein understanding diverse perspectives and attitudes towards illness is paramount. The article argues that differences between patients and physicians are necessary for empathy, while shared similarities form its foundation. Ultimately, a harmonious relationship facilitates empathy and enables the constitution of a new sense of life for both patients and physicians.

Anorexia nervosa through the lens of a severe and enduring experience: 'lost in a big world'

BACKGROUND

Severe and enduring anorexia nervosa (SE-AN), is a serious and persistent illness, despite 'state of the art' treatment. Criteria have been theoretically proposed, but not tested, and may not adequately capture illness complexity, which potentially inhibits treatment refinements. The clinical reality of death as an outcome for some people who experience SE-AN (1 in 20) and broadening access to voluntary assisted dying, further complicates the field, which is undeveloped regarding more fundamental concepts such as nosology, treatment, recovery definitions and alternative conceptualisations of SE-AN. The present paper is in response to this and aims to build upon qualitative literature to enhance phenomenological understandings of fatal SE-AN.

METHOD

A published book, being the legacy of a 32-year-old professional artist offers a rich account of a life lived with AN, for 18 years with continuous treatment. A polysemous narrative via the interrelationship between the languages of the artist's words and visual art is translated via interpretative phenomenological analysis (IPA), offering rich insight into the SE-AN experience.

FINDINGS

The process of analysis induced three superordinate themes (1) Disappearing Self (2) Dialectical Dilemma (3) Death and Dying: Finding Meaning. Two cross cutting themes traversed these themes: (a) Colour and (b) Shifting Hope, where the former produced a visual representation via the 'SE-AN Kaleidoscope'. Collectively the themes produce a concept of SE-AN, grounded in the data and depicted visually through the artist's paintings.

CONCLUSIONS

The picture of SE-AN revealed in the analysis extends upon conceptualisations of SE-AN, highlighting key processes which are thus far under explored. These factors are implicated in illness persistence eliciting opportunities for further research testing including diagnostic considerations and treatment directions. In SE-AN, distorted body image extends to a global distortion in the perception of self. Additional criteria for the severe and enduring stages of illness related to (1) self and identity processes (2) measures of 'global impoverishment' across life domains are proposed for consideration in the future testing of putative defining features of SE-AN.

On mental pain and suicide risk in modern psychiatry

Facing suicide risk is probably the most difficult task for clinicians when dealing with patients in crisis. It requires professional, intellectual, and emotional efforts. Suicide risk assessment can sometimes be distressing for clinicians, and such a state may favour the avoidance of an in-depth exploration of suicidal thoughts and behaviour. Patients often feel subjected to interpersonal assessments with little opportunity to explore their perspectives. The "One size fits all" approach tends to create distance and paradoxically contributes to an increase in the risk of suicide. Traditional clinical factors may be of limited value if a shared understanding of the patient's suicide risk is missed. To understand the suicidal mind, it is necessary to take the point of view of the subject in crisis. In this essay, the "operational model of mental pain as a main ingredient of suicide" provided by Edwin Shneidman' is overviewed with the aim of a better empathic understanding of patients' sufferance. With a phenomenological approach, the suicidal crisis appears as a complex, pervasive state rather than as a symptom of a mental disorder, as the new paradigm also suggests. In this regard, the "mentalistic" aspects of suicide propose a broader insight into the suicidal scenario far beyond the diagnosis of psychiatric disorders. In this article, the perspective of individuals who deem their mental pain to be intolerable is described to make sense of their ambivalence between the wish to die and the wish to live that can prevail if relief is provided.

The primacy of ocular perception: a narrative review on the role of gender identity in eating disorders

BACKGROUND

Phenomenological research has enriched the scientific and clinical understanding of Eating Disorders (ED), describing the significant role played by disorders of embodiment in shaping the lived experience of patients with ED. According to the phenomenological perspective, disorders of embodiment in ED are associated with feelings of alienation from one's own body, determining an excessive concern for external appearance as a form of dysfunctional coping. The purpose of the present narrative review is to address the role of gender identity as a risk factor for EDs in the light of phenomenological approaches.

METHODS

Narrative review.

RESULTS

The current study discusses the interplay between perception, gender identity, and embodiment, all posited to influence eating psychopathology. Internalized concerns for body appearance are described as potentially associated with self-objectification. Furthermore, concerns on body appearance are discussed in relation to gendered social expectations. The current review also explores how societal norms and gender stereotypes can contribute to dysfunctional self-identification with external appearances, particularly through an excessive focus on the optical dimension. The socio-cultural perspective on gender identity was considered as a further explanation of the lived experience of individuals with ED.

CONCLUSIONS

By acknowledging the interplay between these factors, clinicians and researchers can gain a deeper understanding of these disorders and develop more effective interventions for affected individuals.

LEVEL OF EVIDENCE

Level V narrative review.

[Pain and its limits : A phenomenological consideration of chronic pain]

Chronic pain poses a significant global socio-medical challenge causing significant costs. It is only since the mid-20th century that pain syndromes have been considered diseases in their own right. According to the definition of the International Association for the Study of Pain, pain is a complex, context-dependent-and hence modifiable-phenomenon. The philosophical view on pain is no less multi-facetted and allows for a wide range of viewpoints. This analysis aims at a characterisation of pain including a-mainly phenomenological and enactivist-philosophical perspective. The discourse will be guided by the concept of the limit(s) of the lived body: what is the relationship between pain and the perception of the lived body's boundaries? Does a reciprocal influence exist? And may the perception be modified in order to reduce the patient's suffering? These musings will also clarify that neurosciences and philosophy are not competing sciences, but rather inform each other.

Qualitative Research Methodology and Applications: A Primer for the Otolaryngologist

OBJECTIVE

Qualitative and mixed methods methodology is becoming more commonplace in otolaryngology as the field strives to understand more complex concepts of the ear, nose, and throat. This methodology can have tremendous utility in studies directed at patient-centered care by offering practical insights and granular detail-directly from patients-which may not be realized by quantitative approaches.

METHODS

Narrative Review.

RESULTS

This review focuses on what questions can be answered by qualitative research, the basics of the underlying principals and different methodologies utilized, and describes the pearls, pitfalls, and rigor of qualitative research.

CONCLUSIONS

This understanding of qualitative inquiry is critical for the otolaryngologist to stay current on what is published and have the ability to include this in their research repertoire. Laryngoscope, 134:27-31, 2024.

Properties of imagined experience across visual, auditory, and other sensory modalities

Little is known about the perceptual characteristics of mental images nor how they vary across sensory modalities. We conducted an exhaustive survey into how mental images are experienced across modalities, mainly targeting visual and auditory imagery of a single stimulus, the letter "O", to facilitate direct comparisons. We investigated temporal properties of mental images (e.g. onset latency, duration), spatial properties (e.g. apparent location), effort (e.g. ease, spontaneity, control), movement requirements (e.g. eye movements), real-imagined interactions (e.g. inner speech while reading), beliefs about imagery norms and terminologies, as well as respondent confidence. Participants also reported on the five traditional senses and their prominence during thinking, imagining, and dreaming. Overall, visual and auditory experiences dominated mental events, although auditory mental images were superior to visual mental images on almost every metric tested except regarding spatial properties. Our findings suggest that modality-specific differences in mental imagery may parallel those of other sensory neural processes.

Affective Permeability: On Hysteria and Atmospheres

BACKGROUND

Phenomenological literature has recently given much attention to the concept of atmosphere, which is the pre-individual affective tonality of the intersubjective space. The importance of atmospheres in psychopathology has been described for various disorders, but little is known about the interaction with hysteria. The aim of the present paper was to describe the psychopathology of hysteria from the angle of the phenomenon of atmosphere, focussing on the hysterical person's peculiar "affective permeability".

SUMMARY

Hysterical people have difficulty defining themselves autonomously. As compensation, they adopt models transposed from the external environment such as social gender stereotypes or are influenced by the gaze and desire of others. They also possess a special sensitivity in perceiving the affectivity present in a given social situation, by which they are easily impressed and influenced. Their sensibility to environmental affectivity may allow them to take centre stage, assuming the postures and behaviours that others desire and that they sense by "sniffing" the atmosphere in which the encounter is immersed. Thus, a paradox may take place: sensibility is not mere passivity in hysteria but may become a tool for "riding" the emotional atmosphere and manipulating it.

KEY MESSAGES

Affective permeability to environmental atmospheres and manipulation of the environment are the two sides of the same coin. This overlap of passive impressionability and active manoeuvring is necessary to be grasped in the clinical encounter with hysterical persons not to be submerged by their theatricality, that is, by the hyper-intensive expressivity of their feelings and behaviours.

Delineating family needs in the transition from hospital to home for children with medical complexity: part 2, a phenomenological study

BACKGROUND

A systematic literature review on the transition from hospital-to-home (H2H) of families with a child with medical complexity (CMC), resulted in nine overarching themes. These demonstrated common needs and experiences despite the widely differing CMC diagnoses and family characteristics. However, none of the reported studies was conducted in the Netherlands, which hampers the creation of a tailored H2H care pathway, deemed essential for our recently established Transitional Care Unit in the Netherlands: the 'Jeroen Pit Huis'. Therefore, the aim of this study was to gain a deeper understanding of the needs and experiences of Dutch CMC parents on H2H transition and integrate these insights with the literature review into an evidence-based H2H care pathway for CMC and their families.

METHODS

A descriptive phenomenological approach was applied. Heterogeneous purposeful sampling methods were used to recruit participants according to the following criteria: parents of CMC from various regions in the Netherlands, who spoke Dutch fluently and who had been discharged home from a tertiary hospital within the previous five years. Semi-structured, open-ended interviews were conducted via video call by two researchers, who transcribed the audio recordings verbatim. Thematic analysis methods were used to identify emerging themes from the individual transcripts, involving a third and fourth researcher to reach consensus.

RESULTS

Between March and August 2021, 14 mothers and 7 fathers participated in 14 interviews. They elaborated on the H2H transition of 14 CMC with a wide range of underlying diseases: 7 male, 7 female, aged 6 months to 10 years. Eight overarching themes, consistent with the results of the systematic review, represent CMC parental needs and experiences during the H2H process in the Netherlands: (1) autonomy, (2) division of tasks and roles, (3) family emotions, (4) impact on family life, (5) communication, (6) coordination of care, (7) support system and (8) adaptation.

CONCLUSIONS

The H2H needs and experiences reported by the CMC families in this study align with the results of our systematic review. The H2H transition process is not linear but continuous, and should extend beyond the specific medical needs of the CMC to holistic care for the family as a whole. The overarching care needs and experiences, expressed by all CMC families, regardless of underlying symptoms and diagnoses, inform the H2H care pathway and its future evaluation. Our studies highlight the necessity to focus on the family needs rather than on the specific illness of the child, as well as the value of our interdisciplinary care team partnering with parents in the 'Jeroen Pit Huis' towards a safe and sustainable transition home.

Emotions of the pandemic: phenomenological perspectives

This article provides an introduction to the special issue "Emotions of the Pandemic: Phenomenological Perspectives". We begin by outlining how phenomenological research can illuminate various forms of emotional experience associated with the exceptional circumstances of the COVID-19 pandemic. In addition, we propose that a consideration of pandemic experience, in all its complexity and diversity, has the potential to yield wider-ranging phenomenological insights. We go on to discuss the thirteen contributions that follow, identifying common themes and points of complementarity.

Treating black patients as "knowers"

Recent trends in healthcare policy from high-volume service models to "high-value" delivery systems have refocused the need for patient-centered approaches to quality care. However, benchmarks of how to define and evaluate successful patient-centeredness have not been sufficiently established. Such ill-defined evaluation criteria can further exacerbate systemic inequities in maximum quality health care delivery, especially based on the intersectional diversity of various patient populations. In this context, applying a phenomenology of medicine framework or perspective-driven analysis is useful in defining cross-cultural patient-centeredness. This reframing from a naturalistic or objective/biological viewpoint to a phenomenological viewpoint may aid in placing greater epistemic or knowledge authority in the hands of vulnerable and/or marginalized patients- allowing these patients to become key "knowers" in the clinical interaction. Moreover, treating Black patients as "knowers" emphasizes the prioritization of patient values at the core of providing valuable healthcare. Such an academic, policy, and clinical approach to medicine agrees with well-established principles of medical ethics. In addition, the framework of a phenomenology of medicine can better facilitate physician-patient communication and interaction by delineating often muddled hermeneutics.

A phenomenological, intersectional understanding of coping with ageism and racism among older adults

The aim of this qualitative, phenomenological study was to understand how older adults cope with experiences of ageism and racism through an intersectional lens. Twenty adults 60+ residing in the U.S. Mountain West who identified as Black, Hispanic/Latino(a), Asian-American/Pacific Islander, Indigenous, or White participated individually in a one-hour, semi-structured interview. A team of five coders engaged in an inductive coding process through independent coding followed by critical discussion. Peer debriefing enhanced credibility. Nine themes were organized by three umbrella categories: Coping with ageism: 1) distancing via self-determination/defying stereotypes, 2) distancing by helping others; Coping with racism: 3) resistance, 4) exhaustion; Coping with both ageism and racism: 5) increased awareness through aging, 6) healthy lifestyle, 7) education, 8) acceptance/ 'let it go', and 9) avoidance. Novel findings include how older adults may cope with ageism and racism via increased awareness through aging and with ageism specifically by helping peer older adults, although instances of internalized ageism were noted and discussed. The themes exemplify problem-focused (e.g., helping others) and emotion-focused (acceptance), as well as individual (e.g., self-determination) and collective (e.g., resistance) coping strategies. This study can serve as a resource for practitioners in applying a more nuanced understanding of the ways older adults cope with ageism and racism in later life.

Farmers' Lived Experiences of Water Crisis: Lessons Learned from a Phenomenology Study

Understanding the perception of farmers is essential for successful water resources management especially during water crisis. Therefore, this paper examines farmers' perception about the local water crisis in Gawshan dam basin, Iran. Qualitative phenomenological methodology was used to depict the lived experiences of farmers regarding water crisis. Using critical sampling, out of all water users of the Gawshan dam, the selected participants were farmers having lived experience of water crisis and interested to express and share their experiences. Sixty important statements and five themes were extracted from participants' experiences (PE) in water crisis. Finding showed that farmers have perceived agricultural water crisis at the local level but different pattern of perception also is detected among them. The results also revealed that farmers' perception is related to their direct experience, the way they define water crisis, their memories of water crisis and their expectation of what it holds for future water crisis. It is expected that this study will support decision makers at local level to address water crisis in the region.

Food waste in Indian households: status and potential solutions

According to a report by the Food and Agriculture Organization (FAO), India had the highest number of undernourished people in the world in 2020. The COVID-19 pandemic further exacerbated the problem of world hunger (WHO 2021). According to the Food Waste Index Report, 2021, by United Nations Environment Programme (UNEP) and The Waste and Resources Action Programme (WRAP), 931 million tonnes of food waste was produced in 2019, with households accounting for 61%, food services for 26%, and retail for 13%. The report estimates that Indian households generate 50 kg of food waste per capita per year, resulting in total of 68,760,163 tonnes annually. This study aimed to investigate the reasons for food waste in Indian households and potential solutions to minimize or control food waste using interpretive phenomenological analysis. Reasons for food waste include miscalculations in meal preparation, a lack of appreciation for food, and a weakening of traditional Indian value systems. The study identified two potential solutions for controlling or eliminating food waste: exploring alternative methods of food consumption and enhancing the family culture surrounding food. The study results could potentially guide policymakers and planners in designing policies to address the problem of food waste in Indian households.

Danilo Cargnello and his contribution to the development of phenomenological thought: an overview

Danilo Cargnello was one of the greatest authors of Italian phenomenological psychopathology. He wrote the first articles on the subject in 1947-8, a period in which phenomenological ideas began to spread in Italy. His main contribution was to introduce and disseminate Binswanger's ideas in Italy and to emphasise the anthropological character of Daseinsanalyse. His book analysing results of experimental psychosis constitutes one of the most important and meticulous psychopathological reports of substance-induced psychosis. It is essential to keep alive the knowledge of phenomenological authors such as Cargnello, who are of great clinical and psychopathological relevance, and also to integrate the teachings they have left us into professional training.

The lived experience and meaning of resilience in the setting of chronic illness and low- resource communities of African Americans that reside in Tallahatchie County, Mississippi

The purpose of this descriptive phenomenological study was to explore the lived experience and meaning of resilience of individuals in the setting of chronic illness who reside in low-resource communities of the Mississippi Delta, USA. Descriptive phenomenology and Polk's resilience theory were utilized that focused on the individual's lifeworld and the meaning of resilience. The descriptive phenomenological psychological by reduction method (DPPRM) was used for the analysis and further linked to specific aspects of resilience and Polk's resilience theory operationalized patterns. Findings revealed six themes of the lived experience of the participants that make up the eidetic structure and are linked to multidimensional aspects of resilience to create meaning. Fostering increased resilient pattern development has the potential to improve health outcomes, well-being, and quality of life across the spectrum.

Receiving a gift and feeling robbed: a phenomenological study on parents' experiences of Brief Admissions for teenagers who self-harm at risk for suicide

BACKGROUND

Brief Admission by self-referral is a preventive intervention here intended for individuals who recurrently self-harm and have a history of contact with emergency psychiatric services. Individuals with access to Brief Admission are empowered to self-admit to inpatient care for up to three days per stay and are encouraged to do so before experiencing crisis. Brief Admission was implemented relatively recently in child and adolescent psychiatric settings in Sweden. The purpose of this study was to phenomenologically explore the lived experience of parents whose teenagers, who recurrently self-harm and experience suicidal thoughts, use Brief Admissions.

METHODS

This is a qualitative study using phenomenological psychological analysis. We interviewed 17 parents who had experienced their teenagers using Brief Admissions. The interviews were recorded and transcribed verbatim and analyzed to arrive at the essential meaning structure of the phenomenon of Brief Admissions for the parent.

RESULTS

We identified two essential meaning structures of the parent's experience of their teenager's use of Brief Admissions: being gifted relief and hope or being robbed of everything you believed in. The experience of Brief Admissions as a gift was structured by the following constituents: 'a sense of safety and containment', 'liberation from a hostage situation', 'a return to wellbeing', and 'catalysts for relational shifts'. In contrast, the constituents of the experience of being robbed included 'a tug of war for control', 'an unworthy wasteland', 'abandonment and collapse of authority', and 'no sense of purpose and plan'.

CONCLUSIONS

Brief Admissions may come across as challenging, futile and painful in the life of the parent, yet they may also support a process of recovery and healthy development for the entire family. To realize the full potential of the intervention, mental health professionals providing Brief Admission must be mindful of the challenges the parent may face as their teenager starts self-admitting, tactfully and sensitively preparing the parent for a new parental role.

Intergenerational exploration of traditional practices affecting child health: A phenomenological study

BACKGROUND

All over the world, various traditional practices affect child health. The aim of our research was to explore the changes in traditional practices that affect child health between generations and to investigate the life experiences of generations in depth.

METHODS

Using a phenomenological design, this study was conducted with semi-structured interviews with families of both generations (mothers and daughters). The study was written based on the COREQ checklist.

FINDINGS

Four themes (traditional practices and intergenerational differences, beliefs/emotions related to traditional practices, influence factors in traditional practices, traditional methods in child care) and fourteen sub-themes (change in practices between generations, intergenerational transmission of traditional practices, beliefs in perceived benefits, skepticism and disbelief attitude, emotional reactions and perceiving as unnecessary, mother/mother in-law, traditional knowledge from mothers and grandmothers, family elders, the role of the internet and social media, spiritual practices, use of herbal products, alternative applications to medicines, relaxing applications, health consequences of traditional practices) were generated from the data.

DISCUSSION

According to the findings, some harmless traditional practices are still relevant across generations, while harmful practices are mostly abandoned by new generations. The level of education and access to information has led the new generation to question traditional practices and show more interest in scientific knowledge-based methods.

APPLICATION TO PRACTICE

This research can contribute to advances in child health by helping us understand beliefs, feelings, and influencing factors related to traditional practices. Maternal education and community awareness-raising campaigns can be used to reduce harmful traditional practices.

Parameters of learning during clinical nursing study abroad: Focused analysis of phenomenological data using a change-transformative learning theory lens

AIMS

To explore the nature and extent of learning attained as a result of unaccompanied-by-faculty clinical nursing study abroad experiences and to answer the research question 'what is the nature and extent of learning during study abroad?'.

BACKGROUND

Following the Covid-19 restrictions, international placement opportunities for student nurses are now resuming. In light of this, it is an opportune time for nurse educators to reflect and consider the effectiveness of clinical study abroad placements as contexts of learning, especially in relation to attainment of desired learning outcomes such as personal and professional growth and the development of culturally competent global graduates. This is an important area to research as specific understanding in relation to the extent of learning and variations in learning between students is limited.

DESIGN

The study was situated within the interpretivist paradigm to elicit experiences of study abroad. Aligned to this, a hermeneutic phenomenological methodology was applied to ensure these experiences emerged from the subjective horizon of student nurses.

METHODS

Following ethical approval, two semi-structured interviews per student (post-return and follow-up) were conducted with student nurses who had undertaken a study abroad experience. Phenomenological hermeneutical data analysis for multiple context research was undertaken and a change-transformative learning theory lens was additionally employed to the analysis to differentiate between the extent of and variations in, learning attained. Twenty UK and European student nurses, who were registered onto a study abroad programme prior to the Covid-19 restrictions participated.

RESULTS

Variations between participants were identified in relation to the nature and extent of learning. Participants experienced personal and professional growth and they experienced transformation in relation to self as a person, learner and nurse. However, variations existed when considering the attributes of global graduateness and cultural competence development. Whilst participants changed by expanding their knowledge in relation to global and cultural issues, some participants also appear to have concurrently experienced a reinforcement of ethnocentric frames of reference.

CONCLUSIONS

Analysis revealed that study abroad offered opportunities for students to experience change and transformation. Whilst students demonstrated learning in both the domains of change and transformation, transformative learning in all identified outcome areas was not guaranteed. Whilst transformative learning was apparent when considering personal and professional growth, less extensive learning was demonstrated when considering development of the attributes of global graduateness and cultural competence. The paper therefore recognises the complex nature of study abroad experiences and recommends continued investigation in this field.

Dissociation and Temporality in Substance Abuse: A Clinical Phenomenological Overview

The term "dissociation" encompasses a wide array of symptoms and phenomena, all sharing the common characteristic of involving altered states of consciousness where an individual temporarily loses the sense of continuity of their own identity. In the context of addiction pathology, however, the dissociative paradigm remains a topic of ongoing debate. It fluctuates between the description of individual dissociative symptoms and the notion of post-traumatic dissociation as a structural process. This process involves fragmentation that extends beyond the confines of perception and experience within a singular moment, instead ensuring a persistent discontinuity of the self throughout one's existence. Pathological addiction stresses the question of the donation of sense in this deep and dramatic experience; it situates individuals within a compressed and constricted realm of vital space, alongside a frozen perception of time. Within this context, every emotion, sensation, and comprehension becomes impaired. Consequently, we have embarked on a journey starting with a historical analysis: the aim was to construct an elucidative framework for the dissociative paradigm in the context of addiction. This involves an in-depth exploration of the fundamental constructs of trauma and temporality, examined through the lens of phenomenological perspective.