1
|
Vatne ME, Lohne V, Nåden D. "You get tired of remaining in a state of fear"- professionals' experiences of self-care facing suicidality in psychiatric wards. Int J Qual Stud Health Well-being 2024; 19:2292184. [PMID: 38112269 DOI: 10.1080/17482631.2023.2292184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 12/04/2023] [Indexed: 12/21/2023] Open
Abstract
AIM The aim of this study is to explore mental healthcare professionals (MHCPs) experiences related to own emotions when encountering patients at risk of suicide in psychiatric wards and their family members. METHODOLOGY AND METHODS, PARTICIPANTS AND RESEARCH CONTEXT This study has a qualitative explorative design. Data consist of texts from twelve in-depth interviews with MHCPs belonging to six units in two psychiatric wards. Data were interpreted using a hermeneutical approach based on Gadamer's philosophical hermeneutics. FINDINGS Through an interpretation process, three themes emerged: Enduring own emotions, Balancing emotional engagement and the need to rest, and Being together in the community of colleagues. CONCLUSION This study shows the importance of being aware of own anxiety facing suicidality. MHCPs have to work emotionally and cognitively so that care is not guided by anxiety but by collaboration with the patient and his family members. The study highlights the need for a culture in the mental health service in which the MHCP can reflect on own emotional reactions and thoughts in a collegial environment characterized by openness, generosity and collaboration.
Collapse
Affiliation(s)
- May Elise Vatne
- Oslo Metropolitan University, Faculty of Health, Department of Nursing and Health Promotion, Oslo, Norway
| | - Vibeke Lohne
- Oslo Metropolitan University, Faculty of Health, Department of Nursing and Health Promotion, Oslo, Norway
| | - Dagfinn Nåden
- Oslo Metropolitan University, Faculty of Health, Department of Nursing and Health Promotion, Oslo, Norway
| |
Collapse
|
2
|
Russell-Mayhew S, Estefan A, Moules NJ, Lefebvre D, Morhun JM, Saunders JF, Wong K, Myre M. The optics of weight: expert perspectives from the panopticon and synopticon. Psychol Health 2024; 39:823-837. [PMID: 36062741 DOI: 10.1080/08870446.2022.2117810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 08/11/2022] [Accepted: 08/22/2022] [Indexed: 10/14/2022]
Abstract
Objective: That we all weigh something is a fact of life, yet the material reality of weight is refracted through multiple layers of surveillance revealing contradictions in experience and understanding, depending on one's vantage point. We explored the complexities of weight with the specific aim of furthering understanding of this multifaceted surveillance. Methods and Measures: We used hermeneutics, the philosophy and practice of interpretation, as the method of inquiry. Ten experts by experience and seven professional experts participated in interviews, which were audio- recorded, transcribed, and analyzed. Interpretations were developed through group discussions among the eight authors and reiterative writing. Results: Using the metaphor of optics, we demonstrate how the interplay of the panopticon (the few watching the many) and synopticon (the many watching the few) help us gain a deeper understanding of weight through "fitting in," being "captured by numbers," "dieting: the tyrannic tower," and "the male gaze." Conclusion: Monitoring and judging body weight have become so normative in Western society that "weight watching" practices are synonymous with good citizenship and moral character. This study offers insight about how weight is conceptualized in personal and professional contexts, with implications for body image, dieting, eating disorders, public health, and weight bias.
Collapse
Affiliation(s)
- Shelly Russell-Mayhew
- Werklund School of Education Department of Counselling Psychology, University of Calgary, Calgary, AB, Canada
| | - Andrew Estefan
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | - Nancy J Moules
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | - Danielle Lefebvre
- Werklund School of Education Department of Counselling Psychology, University of Calgary, Calgary, AB, Canada
| | - Janelle M Morhun
- Werklund School of Education Department of Counselling Psychology, University of Calgary, Calgary, AB, Canada
| | - Jessica F Saunders
- Psychology Convening Group, Ramapo College of New Jersey, Mahwah, NJ, USA
| | - Katherine Wong
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | - Maxine Myre
- Werklund School of Education Department of Counselling Psychology, University of Calgary, Calgary, AB, Canada
| |
Collapse
|
3
|
Björkmark M, Andtfolk M, Nyholm L. Experiences of caring after religious disaffiliation: A qualitative study based on the DEW model. Scand J Caring Sci 2024. [PMID: 38572619 DOI: 10.1111/scs.13259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 03/13/2024] [Accepted: 03/23/2024] [Indexed: 04/05/2024]
Abstract
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.
Collapse
Affiliation(s)
- Maria Björkmark
- Department of Caring Science, Åbo Akademi University, Vaasa, Finland
| | - Malin Andtfolk
- Department of Caring Science, Åbo Akademi University, Vaasa, Finland
| | - Linda Nyholm
- Department of Caring Science, Åbo Akademi University, Vaasa, Finland
- Department of Caring and Ethics, University of Stavanger, Stavanger, Norway
| |
Collapse
|
4
|
Abstract
Hermeneutics is an important philosophical mode of inquiry where discipline-specific theories and methodologies provide important windows of understanding human experiences. The author discusses the embedded truths of ethics found in the formal inquiry where human living quality phenomena are highlighted. The valuable insights and the importance to the future of the discipline of nursing focus on ideas for suggested further study.
Collapse
|
5
|
Ortiz MR. Leading-Following Interpretations: Living Quality and Working, the Musical. Nurs Sci Q 2024; 37:173-180. [PMID: 38491880 DOI: 10.1177/08943184231224418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2024]
Abstract
It is important to explore the ways that the working lives of persons provides meaning in personal, professional, and organizational ways. In this paper, the author utilized the processes of Parse's (2021a) humanbecoming hermeneutic sciencing (discoursing with penetrating engaging, interpreting with quiescent beholding, and understanding with inspiring envisaging) and the leading-following model to further understanding of the meaning of "working" through Stephen Schwarz's Broadway show, Working, the Musical (Browning & Schwartz, 1982/2002). Although not a formal sciencing project, this interpretive reflection provided a way to "see" how work is "lived out" uniquely.
Collapse
Affiliation(s)
- Mario R Ortiz
- Decker Endowed Chair in Community Health Nursing, Decker College of Nursing and Health Sciences, Binghamton University, State University of New York, Binghamton, NY, USA
| |
Collapse
|
6
|
Butcher HK. The Role of Metaphor in Hermeneutic Research. Nurs Sci Q 2024; 37:105-108. [PMID: 38491879 DOI: 10.1177/08943184241226683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2024]
Abstract
The identification and interpretation of metaphor is useful to hermeneutic research. Metaphor is a way of conceiving one concept in terms of another and serves as a function of understanding. The author explores the rise of hermeneutics research and its relevance to nurse artsciencing. Metaphors are a creative strategy hermeneutic researchers can use to analyze and interpret data, and serve as a powerful strategy to represent complex realities, illuminate unnoticed aspects of a phenomenon, and provide depth of meaning to the understanding of human experiences.
Collapse
Affiliation(s)
- Howard K Butcher
- Professor and Director of PhD Program, Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, USA
| |
Collapse
|
7
|
Kabigting ENR. Paradoxes in Humanbecoming Hermeneutic Sciencing. Nurs Sci Q 2024; 37:103-104. [PMID: 38491884 DOI: 10.1177/08943184231224432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2024]
Abstract
The author explores humanbecoming hermeneutic sciencing and provides exemplars of paradoxes that are used by scholars in this mode of inquiry.
Collapse
|
8
|
Abrar S, Hafeez A, Khan MN, Marwat MI. Perspectives of healthcare workers on integrated management of childhood illness in Pakistan: A phenomenological approach. J Child Health Care 2024:13674935241238474. [PMID: 38451029 DOI: 10.1177/13674935241238474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
In 2019, an estimated 5.2 million deaths were reported among children less than 5 years of age. At primary healthcare level, healthcare workers (HCWs) mostly rely on history and clinical findings and less on inadequate diagnostic facilities. To enhance case management skills of HCWs, World Health Organization devised an integrated management of childhood illnesses (IMCI) strategy in 1995, modified to distance learning IMCI in 2014. A qualitative phenomenological study was conducted to explore perceptions of HCWs about standard and distance IMCI. Four focus group discussions were conducted with purposively selected 26 HCWs (IMCI trained) from 26 basic health units of Abbottabad district in Pakistan. Gadamer's philosophical hermeneutics were adopted during the inductive thematic analysis. Five themes that emerged are inexorable health seeking behaviors, IMCI being a comprehensive algorithm for consultation, a tedious protocol, scaling up protocol to specialists and private practitioners, and administrative insufficiency by the department of health. Improvement in case management skills of HCWs was reported as a result of IMCI trainings. It needs administrative support, regulations to control poly-pharmacy and provision of drugs without prescription, and a curb on political and bureaucratic interference.
Collapse
Affiliation(s)
- Saidul Abrar
- Department of Community Medicine, Gajju Khan Medical College, Shah Mansur, Pakistan
| | - Asad Hafeez
- World Health Representative, WHO Country Office, Safat, Kuwait
| | | | - Muhammad Imran Marwat
- Department of Community Medicine and Public Health, Khyber Medical College, Peshawar, Pakistan
| |
Collapse
|
9
|
Koskinen C, Wallgren GC, Thorkildsen KM, Kaldestad K. For the good of the children-Life and ethical values when undergoing paternal alienation and involuntary loss of paternity. Scand J Caring Sci 2024; 38:65-72. [PMID: 37427686 DOI: 10.1111/scs.13191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/17/2023] [Accepted: 06/09/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND AND AIM Today there is an aspiration and desire for fathers to be caring masculinities that build long-term father-child relationships and emotional presence with their children. Previous research shows that life changes where fathers are deprived of the opportunity for equal parenting and close contact with their children affect the fathers' lives and mental health. The aim of this caring science study is thereby to gain a deeper understanding of life and ethical values when undergoing paternal alienation and experiencing involuntary loss of paternity. DESIGN, RESEARCH METHODS, AND PARTICIPANTS The study has a qualitative design. The data collection was carried out in 2021 through individual in-depth interviews according to Kvale and Brinkmann. The five fathers who participated in the interviews had experiences of undergoing paternal alienation and involuntary loss of paternity. The interviews were analysed with a reflexive thematic analysis according to Braun and Clarke. RESULTS Three main themes emerged. Putting yourself aside includes forgetting one's own needs and prioritising the children's and being the best version of oneself for them. In playing with the cards you have been dealt lies an acceptance of life as it has become and also a responsibility not to let the grief take over, by creating new patterns for everyday life and holding up hope. Keeping your dignity as a human being includes being heard, affirmed and consoled, and a form of re-awakening one's dignity as a human being. CONCLUSION It is fundamental to understand the grief, longing and sacrifice that paternal alienation and involuntary loss of paternity cause human life and how every day can be a struggle to hold on to hope, find comfort and reconcile with the situation. The fundamental foundation that makes life worth living is love and responsibility for the good of the children.
Collapse
Affiliation(s)
- C Koskinen
- Department of Caring and Ethics, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - G C Wallgren
- Department of Caring and Ethics, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - K M Thorkildsen
- Department of Health and Caring Sciences, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Stord, Norway
| | - K Kaldestad
- Department of Caring and Ethics, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| |
Collapse
|
10
|
Dornan T, Armour D, McCrory R, Kelly M, Speyer F, Gormley G, Maxwell P. Striking fear into students' hearts: Unforeseen consequences of prescribing education. Med Teach 2024:1-11. [PMID: 38301608 DOI: 10.1080/0142159x.2024.2308061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 01/17/2024] [Indexed: 02/03/2024]
Abstract
PURPOSE Undergraduate medical education (UGME) has to prepare students to do safety-critical work (notably, to prescribe) immediately after qualifying. Despite hospitals depending on them, medical graduates consistently report feeling unprepared to prescribe and they sometimes harm patients. Research clarifying how to prepare students better could improve healthcare safety. Our aim was to explore how students experienced preparing for one of their commonest prescribing tasks: intravenous fluid therapy (IVFT). METHODS Complexity assumptions guided the research, which used a qualitative methodology oriented towards hermeneutic phenomenology. The study design was an uncontrolled and unplanned complex intervention: judicial review of the iatrogenic death of five children due to hyponatraemia in our region had resulted in the recommendation that students' education in 'the implementation of important clinical guidelines' relevant to fluid and electrolyte balance should be intensified. An opportunity sample of 40 final-year medical students drew and gave audio-recorded commentaries on rich pictures. We completed two template analyses: one of participants' transcribed commentaries on the pictures and one using a novel heuristic to analyse the pictures themselves. We then reconciled the two analyses into a single template. RESULTS There were four themes: affects, teaching and learning, contradictions, and the curriculum as a journey. To explore interconnections between themes, we chose the picture best exemplifying each of the four themes and interpreted the curriculum journey depicted in each of them. These interpretations were grounded in each participant's picture, verbal account of the picture, and the aggregate findings of the template analysis. Participants' experiences were influenced by the situated complexity of IVFT. Layered on top of that, contradictions, overlaps, and gaps within the curriculum introduced extraneous complexity. Confusion and apprehension resulted. CONCLUSIONS After spending five years preparing to prescribe IVFT, participants felt unprepared to do so. We conclude that intensive teaching had not achieved its avowed goal of improving students' preparedness for safe practice. Merton's seminal work on the 'unanticipated consequences of purposive social action' suggests that intensive teaching may even have contributed to their unpreparedness.
Collapse
Affiliation(s)
- Tim Dornan
- Centre for Medical Education, Queen's University Belfast, Northern Ireland, United Kingdom
| | - Dakota Armour
- Centre for Medical Education, Queen's University Belfast, Northern Ireland, United Kingdom
| | - Richard McCrory
- Centre for Medical Education, Queen's University Belfast, Northern Ireland, United Kingdom
| | - Martina Kelly
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Frederick Speyer
- Centre for Medical Education, Queen's University Belfast, Northern Ireland, United Kingdom
| | - Gerard Gormley
- Centre for Medical Education, Queen's University Belfast, Northern Ireland, United Kingdom
| | - Peter Maxwell
- Centre for Medical Education, Queen's University Belfast, Northern Ireland, United Kingdom
| |
Collapse
|
11
|
Kalhovde AM, Kitzmüller G. Family Caregivers' Trajectories of Distress While Caring for a Person With Serious Mental Illness. Qual Health Res 2024; 34:154-165. [PMID: 37905732 PMCID: PMC10714708 DOI: 10.1177/10497323231203627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
Serious mental illness (SMI) can significantly impact the lives of individuals and their families. These families often experience great emotional distress over time due to the early onset of SMI, which in turn leads to long-term trajectories and only partial recovery. However, we do not fully understand the emotional distress of family caregivers. Thus, our aim was to enrich the understanding of the lived experiences of family caregivers' emotional trajectories of distress while caring for persons with SMI. We conducted a secondary analysis using a hermeneutic approach to the narratives of seven family caregivers from a study on living with voices unheard by others. Participants' trajectories of emotional distress came forth as being thrust on an unpredictable, intensely worrisome, and indefinite journey. The following themes highlighted this tumultuous journey: fumbling in the dark trying to grasp the incomprehensible, "on your toes"-enduring unpredictability, facing different forms of fear, and battling waves of sadness and regret. Caregivers face multiple threats to their well-being and sometimes even to their health. Their distress appeared to vary according to their relationship with the person with SMI, whether they lived with the ill person, illness trajectory, and amount of violent or suicidal behavior. The results underscore the need for individualized and timely information, opportunities for dialogue with healthcare providers with and without the person with SMI, and inclusion in care planning. Caregivers who have experienced trauma, threats of violence, and rejection require special attention.
Collapse
|
12
|
Tast A, Kasén A, Bölenius K, Hilli Y. Being a Newly Qualified Nurse: A Nordic Focus Group Study. SAGE Open Nurs 2024; 10:23779608241244679. [PMID: 38562954 PMCID: PMC10983789 DOI: 10.1177/23779608241244679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 01/12/2024] [Accepted: 03/17/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction The transition to working life as a newly qualified nurse (NQN) can be challenging, leading to heightened stress levels. While NQNs are generally enthusiastic about starting their careers, they often express concerns about various responsibilities and a perceived lack of experience in independently dealing with clinical care in complex environments. Objective To acquire an in-depth understanding, from a caring science perspective, of what it means to be an NQN during the transition period of the first 18 months in the profession. Methods This study relied on an exploratory qualitative design. The methodological approach followed Gadamer's hermeneutic philosophy. Six focus group interviews were conducted in northern Norway (n = 3) and northern Sweden (n = 3) from January through May 2021. The interpretation of the data was inspired by Fleming et al. Nineteen female and seven male NQNs working in different contexts, including hospitals and municipalities, participated in the study. The consolidated criteria for qualitative research were used to report the results. Results Perspectives on NQNs are presented as three themes: a) the responsibility was perceived as a significant challenge, b) being a nurse is complex and demanding, and c) a desire for personal and professional development. Learning to be a nurse shouldering responsibility necessitates support and guidance from caring and compassionate colleagues and leaders. Conclusions This study sheds light on the importance of creating a workplace culture where NQNs' learning is promoted and supported by designated mentors during their transition to working life. The responsibilities should be aligned with their level of knowledge. It is important that leaders hold developmental dialogues and ensure a career plan for NQNs to continuously develop their knowledge and skills. Intervention studies designed to evaluate the meaning of the support from appointed mentors within structured mentorship programs are needed.
Collapse
Affiliation(s)
- Anette Tast
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
| | - Anne Kasén
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
| | | | - Yvonne Hilli
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
| |
Collapse
|
13
|
Bon Bernard J, Moules N, Tough S, Tryphonopoulos P, Letourneau N. Listening to the Voices of Mothers Who Participated in a Video Feedback Intervention for Postpartum Depression. Glob Qual Nurs Res 2024; 11:23333936241245588. [PMID: 38628401 PMCID: PMC11020710 DOI: 10.1177/23333936241245588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 03/14/2024] [Accepted: 03/18/2024] [Indexed: 04/19/2024] Open
Abstract
Postpartum depression (PPD) symptoms can negatively influence mother-infant interactions. Video-Feedback Interaction Guidance for Improving Interactions Between Depressed Mothers and their Infants (VID-KIDS) is a parenting intervention that allows mothers experiencing PPD symptoms to observe and improve their interactions with their infants. VID-KIDS has also positively influenced infants' stress (cortisol) patterns. There is limited research on maternal perspectives of interventions like VID-KIDS. In this hermeneutic study, four mothers were interviewed to increase understanding of the VID-KIDS experience. Key findings included: 1) VID-KIDS provided an opportunity for mothers with PPD symptoms to positively transform their identity; 2) VID-KIDS provided a chance to witness the mother-infant relationship forming and improve maternal mental health t, and; 3) VID-KIDS provided a space for mothers to dialogue about their experience with PPD symptoms authentically. VID-KIDS promoted healing from PPD as mothers experienced a transformation in how they perceived themselves and their relationships with their infants.
Collapse
|
14
|
Abdulle AA, Borrego N, Lundgren I. Midwives' experiences of encountering immigrant women during labour and birth who do not master the host country's language. A lifeworld hermeneutic study. Scand J Caring Sci 2023; 37:1136-1144. [PMID: 37340891 DOI: 10.1111/scs.13187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/27/2023] [Accepted: 06/04/2023] [Indexed: 06/22/2023]
Abstract
BACKGROUND Immigrant women are in a vulnerable position during labour and birth due to language barriers. Communication with women who do not master the host country's language is difficult for midwives, but there are few studies about midwives' experiences. AIM To explore Norwegian midwives' experiences of encountering immigrant women during labour and birth who do not master the native language. METHOD A hermeneutic lifeworld approach. Interviews with eight midwives working at specialist clinics and hospital maternity wards in Norway. RESULTS The findings were interpreted based on four concepts in the theory "Birth territory: A theory for midwifery practice" by Fahy and Parrat presented in five themes: language barriers can cause disharmony and prevent participation, language barriers can lead to midwifery domination and poorer care, midwives strive for harmony and to be a guardian, medicalisd birth due to language barriers, and disharmony can lead to crossing boundaries. The main interpretation shows that it is midwifery domination and disintegrative power that are prominent. However, the midwives strived to use their integrative power and be guardians, but in doing so they encountered challenges. CONCLUSION Midwives need strategies for better communication with immigrant women involving the women and for avoiding a medicalised birth. To be able to meet immigrant women's needs and to establish a good relationship with them, challenges in maternity care need to be addressed. There are needs of care that focus on cultural aspects, leadership teams that support midwives, and both theoretical and organisational care models that support immigrant women.
Collapse
Affiliation(s)
- Amran Ahmed Abdulle
- Institute of Health Care and Sciences, University in Tromsø (UiT) - Norway's Arctic University, Tromsø, Norway
| | - Natalia Borrego
- Institute of Health Care and Sciences, University in Tromsø (UiT) - Norway's Arctic University, Tromsø, Norway
| | - Ingela Lundgren
- Institute of Health Care and Sciences, University in Tromsø (UiT) - Norway's Arctic University, Tromsø, Norway
| |
Collapse
|
15
|
Paulsen A, Vistad I, Fegran L. Nurse-patient sexual health communication in gynaecological cancer follow-up: A qualitative study from nurses' perspectives. J Adv Nurs 2023; 79:4648-4659. [PMID: 37358051 DOI: 10.1111/jan.15755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 05/18/2023] [Accepted: 06/15/2023] [Indexed: 06/27/2023]
Abstract
AIM To explore nurse-patient sexual health communication from the perspectives of nurses trained to address sexual health in gynaecological cancer follow-up. DESIGN A qualitative hermeneutic approach. METHODS Individual semi-structured interviews with 10 nurses at five different hospitals in Norway were conducted in March and April 2021. A Gadamerian-inspired research method was used in the analysis. RESULTS Three main themes with six sub-themes were identified. The three main themes were: (1) building relationships through communication, (2) practice makes perfect-the importance of experience and knowledge, and (3) personal attitudes as promoters or inhibiters of sexual health communication. CONCLUSION This study provides valuable insights into nurse-patient sexual health communication from the perspectives of nurses. The nurses in this study experienced the importance of having a good, respectful nurse-patient relationship as the foundation for sexual health communication. The professional confidence gained through experience and knowledge was emphasized, including the significance of how attitudes and taboos can influence sexual health communication. IMPACT The main findings of this study indicate that training in sexual health communication and the possibility of addressing sexual health repeatedly give nurses skills and professional confidence to address sexual health in cancer follow-up. Our study indicates that sexual health communication can be achieved in a clinical setting without being overly resource demanding. Our results may also motivate nurses to enhance their knowledge about sexual health in cancer follow-ups. PATIENT OR PUBLIC CONTRIBUTION A patient representative from the Norwegian Gynaecological Cancer Society have been involved in the planning of this study. She has given valuable contributions from the view of a gynaecological cancer patient.
Collapse
Affiliation(s)
- Anita Paulsen
- Department of Research, Sorlandet Hospital, University of Agder, Kristiansand, Norway
- Department of Health and Nursing Sciences, University of Agder, Kristiansand, Norway
| | - Ingvild Vistad
- Department of Gynaecology and Obstetrics, Sorlandet Hospital, Kristiansand, Norway
| | - Liv Fegran
- Department of Health and Nursing Sciences, University of Agder, Kristiansand, Norway
| |
Collapse
|
16
|
Koskinen M, Hilli Y, Keskitalo T, Talvik M, Sandvik AH, Thorkildsen KM, Skyvell-Nilsson M, Koivula M, Šteinmiller J. Ethical dilemmas faced by healthcare teachers during the COVID-19 pandemic. Nurs Ethics 2023:9697330231215957. [PMID: 37997900 DOI: 10.1177/09697330231215957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023]
Abstract
BACKGROUND Previous studies have shown that the rapid transition to emergency remote teaching due to the COVID-19 pandemic was challenging for healthcare teachers in many ways. This sudden change made them face ethical dilemmas that challenged their values and ethical competence. RESEARCH AIM This study aimed to explore and gain a deeper understanding of the ethical dilemmas healthcare teachers faced during the COVID-19 pandemic. RESEARCH DESIGN This was an inductive qualitative study using a hermeneutic approach. Semi-structured interviews were conducted and analysed thematically. PARTICIPANTS AND RESEARCH CONTEXT Healthcare teachers (n = 20) from eight universities and universities of applied sciences in the Nordic and Baltic countries participated. ETHICAL CONSIDERATIONS This study was based on the research ethics of the Norwegian National Research Ethics Committee for Medicine and Health Sciences and approved by the Norwegian Agency for Shared Services in Education and Research. FINDINGS Healthcare teachers faced several ethical dilemmas due to restrictions during the COVID-19 pandemic. The analysis revealed three main themes: How should I deal with students' ill-being, and what can I as a teacher do?; What can I demand from myself and my students, what is good teaching?; How do I manage the heavy workload and everyone's needs, and who gets my time? CONCLUSIONS This study highlights the importance of healthcare teachers' continuous need for pedagogic and didactic education, especially considering new technology and ethical issues. During the pandemic, the ethical consequences of remote teaching became evident. Ethical values and ethical dilemmas should be addressed in healthcare education programmes at different levels, especially in teacher education programmes. In the coming years, remote teaching will grow. Therefore, we need more research on this issue from an ethical perspective on its possible consequences for students and healthcare teachers.
Collapse
|
17
|
Smith KS, Kinsella EA, Moodie S, McCorquodale L, Teachman G. Mindfulness and therapeutic relationships: A phenomenological inquiry into paediatric occupational therapists' practices. Scand J Occup Ther 2023; 30:1441-1450. [PMID: 37256557 DOI: 10.1080/11038128.2023.2217670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 05/19/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND A growing body of literature points to the potential of mindfulness to support therapeutic relationships, and the importance of the therapeutic relationship when working with children and youth, yet little attention has been paid to this topic in occupational therapy. AIMS/OBJECTIVES The aim of this study was to inquire into occupational therapists' experiences of mindfulness in the therapeutic relationship with children and youth. MATERIALS AND METHODS Hermeneutic phenomenology was the methodological approach, with Heidegger's concepts of being-with and care as theoretical underpinnings of the study. Eight North American occupational therapists participated in semi-structured interviews that elicited first-hand accounts of mindfulness in the therapeutic relationship with children and youth. Interviews were transcribed verbatim and analysed using a phenomenological approach. RESULTS Four key themes were identified: fostering a safe space, enhancing presence, being authentic, and cultivating acceptance. CONCLUSIONS AND SIGNIFICANCE The findings offer insights regarding the potential affordances of mindfulness to support clinicians in the development of therapeutic relationships with children and youth. Further, this study highlights research priorities for future inquiry.
Collapse
Affiliation(s)
- Kirsten Sarah Smith
- Graduate Program in Health and Rehabilitation Sciences, University of Western Ontario, London, Canada
| | - Elizabeth Anne Kinsella
- Graduate Program in Health and Rehabilitation Sciences, University of Western Ontario, London, Canada
- Department of Medicine and Health Sciences, McGill University, Montreal, Canada
| | - Sheila Moodie
- Graduate Program in Health and Rehabilitation Sciences, University of Western Ontario, London, Canada
- National Centre for Audiology, University of Western Ontario, London, Canada
| | - Lisa McCorquodale
- Graduate Program in Health and Rehabilitation Sciences, University of Western Ontario, London, Canada
- School of Occupational Therapy, University of Western Ontario, London, Canada
| | - Gail Teachman
- Graduate Program in Health and Rehabilitation Sciences, University of Western Ontario, London, Canada
- School of Occupational Therapy, University of Western Ontario, London, Canada
| |
Collapse
|
18
|
Rykkje L, Morland M, Ferstad K, Kuven BM. A qualitative hermeneutical understanding of spiritual care in old age when living in a nursing home: The residents' voices. J Clin Nurs 2023; 32:7846-7859. [PMID: 37574799 DOI: 10.1111/jocn.16855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 06/19/2023] [Accepted: 07/31/2023] [Indexed: 08/15/2023]
Abstract
AIM To explore and gain a broader understanding of residents' viewpoints and experiences of spiritual care when living in a nursing home. DESIGN A qualitative hermeneutical interview study inspired by Gadamer's philosophical hermeneutics. METHODS Thirty-eight individual interviews of 14 male and 24 female residents; of these, 24 had a dementia diagnosis. The setting was one large Norwegian nursing home providing long-term care. FACIT-Sp-12 was used as a guide for the interview, in addition to two open-ended questions about thriving and spiritual care. FINDINGS The older residents' voices portray a broad and diverse understanding of spiritual care, and four themes emerged: (1) Spiritual at-homeness, (2) Spiritual awareness, (3) Philosophy of life and (4) Interconnectedness. CONCLUSION Accepting one's life situation in a nursing home can foster a feeling of belonging, leading to feeling more at-home. Spiritual well-being, including finding purpose, spiritual awareness and beliefs, was found to be interconnected with spiritual at-homeness in the nursing home. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE This study provides insights into older nursing home residents' viewpoints on spiritual care, including persons living with dementia. IMPACT The study addressed the limited evidence regarding how older residents themselves experience and express spiritual care. Listening to older nursing home residents' voices provides a unique contribution to the research field. As several individuals with dementia contributed to the findings, this study mirrors the current population of residents in nursing homes. The findings may inform healthcare provision and policymakers and impact upon spiritual care in the field of older people nursing and dementia care services. REPORTING METHOD The COREQ guideline. PATIENT OR PUBLIC CONTRIBUTION Participation through interviews of nursing home residents.
Collapse
Affiliation(s)
- Linda Rykkje
- Institute of Health, Faculty of Health Studies, Bergen, Norway
| | | | - Kristin Ferstad
- Institute of Nursing, Faculty of Health Studies, Bergen, Norway
| | | |
Collapse
|
19
|
Ramsey SM, Brooks J, Briggs M, Hallett CE. Voiceless and vulnerable: An existential phenomenology of the patient experience in 21st century British hospitals. Nurs Inq 2023; 30:e12588. [PMID: 37501278 DOI: 10.1111/nin.12588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 07/12/2023] [Accepted: 07/14/2023] [Indexed: 07/29/2023]
Abstract
Current health policy, high-profile failures and increased media scrutiny have led to a significant focus on patient experience in Britain's National Health Service (NHS). Patient experience data is typically gathered through surveys of satisfaction. The study aimed to support a better understanding of the patient experience and patients' expression of it through consideration of the aspects of the patient experience on NHS wards which are by their nature impossible to capture through patient satisfaction surveys. Existential phenomenology was used to develop an in-depth exploratory narrative, expressed through the voices of the participants. Data collection involved in-depth face-to-face interviews with 12 purposively sampled participants, with analysis by means of hermeneutics. Though the individuality of each experience was apparent and cannot be overemphasised, common factors emerging from the data included uncertainty and unexpectedness, suffering and finitude, the futility of feedback and bureaucracy and absurdity. Overall, participants demonstrated how their individual personalities and expectations affected their response both to illness or injury and to their hospital admissions, highlighting feelings of vulnerability and voicelessness as a response to hospitalisation. The findings of this study provide useful insight into the patient experience on British hospital wards, and the value of an existential-phenomenological approach is demonstrated.
Collapse
Affiliation(s)
- Sarah M Ramsey
- Trafford General Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Jane Brooks
- School of Health Sciences, The University of Manchester, Manchester, UK
| | - Michelle Briggs
- School of Health Sciences, The University of Manchester, Manchester, UK
| | - Christine E Hallett
- School of Music, Humanities and Media, The University of Huddersfield, Huddersfield, UK
| |
Collapse
|
20
|
Foley K, Lunnay B, Kevin C, Ward PR. Developing a Women's Thought Collective methodology for health research: The roles and responsibilities of researchers in the reflexive co-production of knowledge. Health Expect 2023; 26:1954-1964. [PMID: 37522791 PMCID: PMC10485336 DOI: 10.1111/hex.13804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 06/09/2023] [Accepted: 06/10/2023] [Indexed: 08/01/2023] Open
Abstract
BACKGROUND Co-produced research holds enormous value within the health sciences. Yet, there can be a heavy focus on what research participants think, do and know; while the researcher's responsibility to explore and re/work their own knowledge or praxis tends to escape from view. This is reflected in the limited use of co-production to explore broad structural distributions of health and risk(s). We argue this missed opportunity has the potential to unfold as what Berlant calls a 'cruel optimism', where something desirable becomes an obstacle to flourishing and/or produces harm. We explore challenges to involving lay populations meaningfully in health research amidst a neoliberal cultural landscape that tends to responsibilise people with problems they cannot solve. METHODS AND FINDINGS Drawing together principles from hermeneutic and feminist philosophy, we develop a novel methodology for co-producing research about determinants of health and health risk (using a case study of alcohol consumption as an example) that centres on what researchers do, know and think during research: Women's Thought Collectives. DISCUSSION Keeping the constructed nature of social systems-because they shape ideas of value, expertise and knowledge-in view during co-produced research illuminates the potential for cruel optimisms within it. Such reflexive awareness carves out starting points for researchers to engage with how social hierarchies might (tacitly) operate during the co-production of knowledge. Our work has broad utility for diverse population groups and provides important considerations around the roles and responsibilities for reflexive co-production of knowledge at all levels of health systems. PATIENT OR PUBLIC CONTRIBUTION The development of these ideas was sparked by working with lay participants during the Women's Thought Collectives for Kristen Foley's doctoral research 2021-2023, but undertaken without their direct involvement-in accordance with the responsibilities of researchers in the reflexive co-production of knowledge. Forthcoming publications will address the outcomes and processes of this work.
Collapse
Affiliation(s)
- Kristen Foley
- Research Centre for Public Health, Equity and Human FlourishingTorrens University AustraliaAdelaideAustralia
| | - Belinda Lunnay
- Research Centre for Public Health, Equity and Human FlourishingTorrens University AustraliaAdelaideAustralia
| | - Catherine Kevin
- College of Humanities and Social ScienceFlinders UniversityAdelaideAustralia
| | - Paul R. Ward
- Research Centre for Public Health, Equity and Human FlourishingTorrens University AustraliaAdelaideAustralia
| |
Collapse
|
21
|
Pelters P, Galanti MR. "It's nice to just be": A qualitative study on the meaning-imbued reality of waterpipe smoking among young adults in Sweden. Nordisk Alkohol Nark 2023; 40:482-501. [PMID: 37969904 PMCID: PMC10634388 DOI: 10.1177/14550725231195183] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 08/01/2023] [Indexed: 11/17/2023] Open
Abstract
Background and aims: Waterpipe smoking is regarded as a burgeoning public health problem due to its popularity among young adults. This study aims to understand the meaning-imbued reality of waterpipe smoking for young adults in Sweden. Method: Data from 18 individual interviews with ethnically diverse Swedish young adults were analysed using inductive latent-level qualitative content analysis. Results: The youth's experience of waterpipe smoking shows different dimensions (time, space, fun, community) that construct the practice of waterpipe smoking as a closed bubble characterised by harmlessness, cosiness and freedom to develop an adult self in the waterpipe group. The bubble provides a breathing space and timeout in everyday life, fuelled by an understanding of the hookah as hazard-free and liberating. A variety of control mechanisms are used to defend the bubble's constructed harmlessness, proving responsibility by applying practice-, communication- and Othering-oriented means. Conclusion: The study enhances the understanding of waterpipe smoking by highlighting its community- and self-forming meaning in a combined focus on ritualistic and symbolic qualities. For young adults, waterpipe smoking combines potentially beneficial and detrimental impacts on health. This complex situation requires a dialogical - rather than a traditional - approach to prevention that negotiates the risk landscape faced by young adults.
Collapse
Affiliation(s)
- Pelle Pelters
- Department of Education, Stockholm University, Stockholm, Sweden
| | - Maria Rosaria Galanti
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden; Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden
| |
Collapse
|
22
|
Saadatmehr SR, Sanagoo A, Jafari Rad A, Bakhshian F, Jouybari L. The Living Experience of Patients with Burn Injuries from Art Nursing Care: An Unspoken Mystery. Iran J Nurs Midwifery Res 2023; 28:616-623. [PMID: 37869696 PMCID: PMC10588922 DOI: 10.4103/ijnmr.ijnmr_2_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 07/21/2023] [Accepted: 07/23/2023] [Indexed: 10/24/2023]
Abstract
Background Although art and aesthetics are important aspects in nursing care, there is scarcity of literature regarding this area, particularly in relation to patient expectations of art nursing care. This study aims to explore the perceptions of patients with burn injuries regarding art nursing care. Materials and Methods The present phenomenological study was conducted on 14 patients with burn injuries based on convenience and purposive sampling. Data were collected through deep open-ended and semi-structured interview. Data analysis was performed based on van Manen's Hermeneutic Phenomenology. Results Patients' experience of art nursing care emerged in the form of three main themes, including "being a healer for patients' wounds", "skilled and specialized care", "praiseworthy care", and six subthemes. Conclusions The patients in the burn unit demonstrated an understanding and appreciation for the qualities of patience, hard work, compassion, and love that the nurses possess. They also noted the meticulous attention paid by the nurses to their needs, which exemplifies the purest human traits and professional characteristics in patient care and can be seen as an art form in nursing.
Collapse
Affiliation(s)
| | - Akram Sanagoo
- Department of Nursing, Faculty of Nursing and Midwifery, Golestan University of Medical Sciences, Gorgan, Iran
| | | | - Fereshteh Bakhshian
- Department of Psychology, Faculty of Social Sciences, Razi University, Kermanshah, Iran
| | - Leila Jouybari
- Department of Nursing, Faculty of Nursing and Midwifery, Golestan University of Medical Sciences, Gorgan, Iran
| |
Collapse
|
23
|
Paul R, Andersson E, Olbers T, Frisk J, Berterö CM. Women's lived experiences of sex hormones and life-related to bariatric surgery: an interpretative qualitative study. BMJ Open 2023; 13:e072085. [PMID: 37355262 PMCID: PMC10314659 DOI: 10.1136/bmjopen-2023-072085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 06/13/2023] [Indexed: 06/26/2023] Open
Abstract
OBJECTIVES The study aimed to explore the lived experiences of women with severe obesity before and after undergoing bariatric surgery with a special focus on possible effects of changed sex hormone levels. DESIGN A qualitative interview study with transcribed text analysis based on Gadamer's hermeneutics. SETTING Regional hospital and outpatient bariatric clinic in central Sweden. PARTICIPANTS Ten women (age 23-38 years) having undergone Roux-en-Y gastric bypass surgery between 2016 and 2019 were interviewed. RESULTS The transcribed interviews were analysed according to Gadamer's hermeneutics. Text horizons, interpreter horizons and fact horizons were derived and formed the fusions 'Recognition of unhealthy body weight', 'Dealing with other people's opinions and society's norms', 'Life has changed in a positive way' and 'Accepting inner self and bodily changes'. CONCLUSION Women highlighted weight and body size in their responses. The study provided a deeper understanding of the situation of women living with obesity and pros and cons of having undergone bariatric surgery. Experiences of changes in sex hormones and fertility were discussed but not central to the informants. Participants emphasised the need to be prepared and properly supported in dealing with changes in life after bariatric surgery and subsequent weight loss.
Collapse
Affiliation(s)
- Rebecca Paul
- Department of Surgery, Falun County Hospital, Center for Clinical Research Dalarna, Falun, Sweden
- Department of Surgery and Department of Biomedical and Clinical Sciences, Linköping University, Norrköping, Sweden
| | - Ellen Andersson
- Department of Surgery and Department of Biomedical and Clinical Sciences, Linköping University, Norrköping, Sweden
| | - Torsten Olbers
- Department of Surgery and Department of Biomedical and Clinical Sciences, Linköping University, Norrköping, Sweden
- Wallenberg Centre for Molecular Medicine, Department of Biomedical and Clinical Sciences, Linköping University, Linkoping, Sweden
| | - Jessica Frisk
- Department of Surgery and Department of Biomedical and Clinical Sciences, Linköping University, Norrköping, Sweden
| | - Carina M Berterö
- Division of Nursing Sciences and Reproductive Health, Institution of Medical and Health Sciences, Linköping University, Linkoping, Sweden
| |
Collapse
|
24
|
Rentmeester C, Liebzeit M. A Gadamerian approach to nursing: Merging philosophy with practice. Nurs Philos 2023:e12453. [PMID: 37312673 DOI: 10.1111/nup.12453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 04/25/2023] [Accepted: 06/01/2023] [Indexed: 06/15/2023]
Abstract
Philosophy is commonly criticized for being too abstract and detached from practical spheres. Upon chronicling how philosophy has gained this reputation, the authors explore the philosophical fields of phenomenology and hermeneutics that have explicitly attempted to merge philosophy with everyday life contexts. In recent decades, phenomenology and hermeneutics have been applied to healthcare. In the realm of nursing, Patricia Benner's nursing theory is especially informed by phenomenology, which is briefly explored through her relationship with one of her mentors, the philosopher Hubert Dreyfus. The authors then turn their attention to Hans-Georg Gadamer's philosophy in an attempt to mine concepts relevant to the practice of nursing. Gadamer juxtaposed the human sciences from the natural sciences and thought that both needed different approaches: whereas natural sciences are guided by episteme, that is, universal knowledge, human sciences are guided by phronesis, that is, practical wisdom. Gadamer's philosophy is especially helpful in understanding how to cultivate phronesis in nursing wherein a nurse relies upon one's clinical experience to masterfully navigate each unique patient relationship. Nurses must serve as authorities in the realm of healthcare but also be open to the authority of their patients, who ultimately choose their course of treatment in our contemporary era of patient autonomy. Gadamer's philosophy can help us understand why phronesis requires not only practice but also reflection on that practice to be appropriately cultivated. The authors apply this to the realm of nursing in showing how both practice-clinically and via simulation-and reflection-through journaling or dialogue-are necessary for phronesis to emerge.
Collapse
|
25
|
Duque PA, Campiño SM, Guarnizo Tole M, Escobar Peláez D. Marie Poussepin's Influence on Nursing from Her Vocation of Service and Charity. Invest Educ Enferm 2023; 41. [PMID: 38589324 DOI: 10.17533/udea.iee.v41n2e06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
Objective This work sought to describe the influence of Marie Poussepin on Nursing from her vocation of service and charity. Methods Historical-hermeneutic study with participation by 15 Dominican Sisters of Charity in the Presentation of the Blessed Virgin from the city of Manizales and Bogotá, Colombia, who answered semi-structured interviews. The information was gathered and recontextualized via the open and axial coding system through ATLAS.ti9 software. During the interpretation procedure, copying, intensive reading, note taking, analysis, first epigraph of the report, coding, grouping, and determination of categories was made, conducting information triangulation with existing evidence. Results Three categories emerged: Responding to the call of Jesus through service to the community; Under the legacy of charity, respect for life and the dignity of human beings, and Caring for life as a foundation of nursing. The second category formulated the description that integrates the course of life and objectives of the institutions where the nuns interviewed work. Conclusion The legacy by Marie Poussepin to nursing care has been manifested since the foundation of the work, influencing the disciplinary work through the vocational commitment of those who make up the congregation, imprinting a character of service and respect for others, in response to the love of God.
Collapse
Affiliation(s)
- Paula Andrea Duque
- Nurse, Master's. Universidad Católica de Manizales. Manizales -Caldas, Colombia.
| | | | | | | |
Collapse
|
26
|
Abstract
The widespread use of faith-based and traditional healing for mental disorders within African contexts is well known. However, normative responses tend to fall within two camps: on one hand, those oriented towards the biomedical model of psychiatry stress the abuses and superstition of such healing, whilst critics adopting a more 'local' perspective have fundamentally challenged the universalist claims of biomedical diagnostic categories and psychiatric treatments. What seemingly emerges is a dichotomy between those who endorse more 'universalist' or 'relativist' approaches as an analytical lens to the challenges of the diverse healing strands within African contexts. In this article, we draw upon the resources of philosophy and existing empirical work to challenge the notion that constructive dialogue cannot be had between seemingly incommensurable healing practices in global mental health. First, we suggest the need for much-needed conceptual clarity to explore the hermeneutics of meaning, practice, and understanding, in order to forge constructive normative pathways of dialogue between seemingly incommensurable values and conceptual schemas around mental disorder and healing. Second, we contextualise the complex motives to emphasise difference amongst health practitioners within a competitive healing economy. Finally, we appeal to the notion of recovery as discovery as a fruitful conceptual framework which incorporates dialogue, comparative evaluation, and cross-cultural enrichment across divergent conceptualisations of mental health.
Collapse
|
27
|
Boyle P, Galvin KT, Vuoskoski P, Stew G. The Experience of Living through the Transition from Adolescence to Adulthood for Young People with Cerebral Palsy. Occup Ther Health Care 2023:1-20. [PMID: 37184443 DOI: 10.1080/07380577.2023.2211669] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
This study explored the lived experience of transition from adolescence to adulthood for young people with cerebral palsy to inform occupational therapy practitioners as to what might promote positive life opportunities. A phenomenological methodology was used with six participants, aged 18 to 25 years with cerebral palsy. The findings are presented in the form of hermeneutic stories and three themes: The storm of uncertainty; time, space and the body, Capsizing in a world of others and, Securing anchorage; being heard and understood. Recommendations include service integration across health, social care and education based on partnership and provision of coordinators.
Collapse
Affiliation(s)
- Paul Boyle
- Occupational Therapy, School of Sport and Health Sciences, University of Brighton, Eastbourne, United Kingdom
| | - Kathleen T Galvin
- School of Sport and Health Sciences, University of Brighton, Brighton, UK
| | - Pirjo Vuoskoski
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Graham Stew
- (Retired), School of Health Sciences, University of Brighton, Eastbourne, UK
| |
Collapse
|
28
|
Macdonald ME, Siedlikowski S, Liu K, Carnevale FA. Introducing SAMMSA, a Five-Step Method for Producing 'Quality' Qualitative Analysis. Qual Health Res 2023; 33:334-344. [PMID: 36745036 PMCID: PMC10061624 DOI: 10.1177/10497323231154482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Qualitative health research is ever growing in sophistication and complexity. While much has been written about many components (e.g. sampling and methods) of qualitative design, qualitative analysis remains an area still needing advanced reflection. Qualitative analysis often is the most daunting and intimidating component of the qualitative research endeavor for both teachers and learners alike. Working collaboratively with research trainees, our team has developed SAMMSA (Summary & Analysis coding, Micro themes, Meso themes, Syntheses, and Analysis), a 5-step analytic process committed to both clarity of process and rich 'quality' qualitative analysis. With roots in hermeneutics and ethnography, SAMMSA is attentive to data holism and guards against the data fragmentation common in some versions of thematic analysis. This article walks the reader through SAMMSA's 5 steps using research data from a variety of studies to demonstrate our process. We have used SAMMSA with multiple qualitative methodologies. We invite readers to tailor SAMMSA to their own work and let us know about their processes and results.
Collapse
Affiliation(s)
| | - Sophia Siedlikowski
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montréal, QC, Canada
| | - Kevin Liu
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montréal, QC, Canada
| | | |
Collapse
|
29
|
Haga BM, Furnes B, Ueland V. Health professionals' reflections on existential concerns among people with obesity. Scand J Caring Sci 2023; 37:185-195. [PMID: 35789028 DOI: 10.1111/scs.13105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 06/15/2022] [Accepted: 06/21/2022] [Indexed: 12/01/2022]
Abstract
PURPOSE This study aimed to describe health professionals' reflections on existential concerns among people with obesity when attempting to support them in their lifestyle change processes. For many of those affected by obesity, the condition becomes lifelong and causes existential concerns. The health professionals' reflections on existential concerns among people with obesity may influence central aspects of their practice and their patients' well-being. METHODS Eighteen health professionals with relevant health education working in three different treatment programmes for people with obesity were recruited for three focus group interviews. The interviews were analysed and interpreted using a model for interpretation of meaning at three levels with a phenomenological-hermeneutical approach. FINDINGS The analysis identified three themes. The health professionals reflected on existential concerns among people with obesity in terms of patients' repressed emotional difficulties and lack of self-respect. In addition, they reflected on their own experiences of powerlessness when presented with people with obesity's existential concerns. CONCLUSION The present study provides valuable insights into reflections on existential concerns among people with obesity, based on health professionals' descriptions. We believe that these insights add to the existing literature and have consequences for how people with obesity are met and cared for.
Collapse
Affiliation(s)
- Britt Marit Haga
- Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Bodil Furnes
- Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Venke Ueland
- Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| |
Collapse
|
30
|
Bragina EY, Puzyrev VP. Genetic outline of the hermeneutics of the diseases connection phenomenon in human. Vavilovskii Zhurnal Genet Selektsii 2023; 27:7-17. [PMID: 36923482 PMCID: PMC10009484 DOI: 10.18699/vjgb-23-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/25/2022] [Accepted: 12/26/2022] [Indexed: 03/11/2023] Open
Abstract
The structure of diseases in humans is heterogeneous, which is manifested by various combinations of diseases, including comorbidities associated with a common pathogenetic mechanism, as well as diseases that rarely manifest together. Recently, there has been a growing interest in studying the patterns of development of not individual diseases, but entire families associated with common pathogenetic mechanisms and common genes involved in their development. Studies of this problem make it possible to isolate an essential genetic component that controls the formation of disease conglomerates in a complex way through functionally interacting modules of individual genes in gene networks. An analytical review of studies on the problems of various aspects of the combination of diseases is the purpose of this study. The review uses the metaphor of a hermeneutic circle to understand the structure of regular relationships between diseases, and provides a conceptual framework related to the study of multiple diseases in an individual. The existing terminology is considered in relation to them, including multimorbidity, polypathies, comorbidity, conglomerates, families, "second diseases", syntropy and others. Here we summarize the key results that are extremely useful, primarily for describing the genetic architecture of diseases of a multifactorial nature. Summaries of the research problem of the disease connection phenomenon allow us to approach the systematization and natural classification of diseases. From practical healthcare perspective, the description of the disease connection phenomenon is crucial for expanding the clinician's interpretive horizon and moving beyond narrow, disease-specific therapeutic decisions.
Collapse
Affiliation(s)
- E Yu Bragina
- Research Institute of Medical Genetics, Tomsk National Research Medical Center of the Russian Academy of Sciences, Tomsk, Russia
| | - V P Puzyrev
- Research Institute of Medical Genetics, Tomsk National Research Medical Center of the Russian Academy of Sciences, Tomsk, Russia Siberian State Medical University, Tomsk, Russia
| |
Collapse
|
31
|
Riley CA, Soneru CP, Navarro A, Trinh L, Abuzeid WM, Humphreys IM, Akbar NA, Shah S, Lee JT, Wu TJ, Schneider JS, McCoul ED. Layperson Perception of Symptoms Caused by the Sinuses. Otolaryngol Head Neck Surg 2023; 168:1038-1046. [PMID: 36939435 DOI: 10.1002/ohn.197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 10/10/2022] [Accepted: 10/20/2022] [Indexed: 02/11/2023]
Abstract
OBJECTIVE To assess the perceived symptoms caused by the sinuses as defined by otolaryngology patients and clinicians. STUDY DESIGN Multi-institutional cross-sectional study. SETTING Six academic outpatient otolaryngology practices. METHODS We performed a multi-institutional, cross-sectional study using a semantics-based questionnaire. Consecutive patients were enrolled at 6 academic otolaryngology centers from June 2020 to May 2021. The primary outcome examined patient and provider definitions for the symptoms caused by the sinuses from a list of 28 proposed terms covering 6 general categories. These data were also collected from otolaryngology faculty at the same institutions. RESULTS Responses were obtained from 451 patients (54% female, mean age 48.3 years) and 29 otolaryngologists (38% female, mean age 37.4 years). Patients selected a median of 12 terms, compared to 8.5 for otolaryngologists. Among patients, the most frequently selected symptom domains were mucus (419, 92.9%), airflow (412, 91.4%), and pain (389, 86.3%). Compared to clinicians, patients more frequently selected symptoms related to the ear (difference, 48.3%; 95% confidence interval [CI], 34.8%-59.3%), throat (difference, 35.7%, 95% CI, 22.0%-47.5%), systemic (difference, 34.4%, 95% CI, 21.2%-46.0%), mucus (difference, 20.5%, 95% CI, 10.2%-30.6%), and airflow domains (difference, 19.0%, 95% CI, 8.4%-29.3%). Multiple domains were selected by 98% of patients and 79% of providers. CONCLUSION Semantic differences exist between patients and clinicians regarding the symptoms caused by the sinus with patients having a broader range of perceived symptoms. These differences may provide clues to improve communication between otolaryngologists and their patients.
Collapse
Affiliation(s)
- Charles A Riley
- Department of Otolaryngology-Head and Neck Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
| | - Christian P Soneru
- Department of Otolaryngology-Head and Neck Surgery, Tufts Medical Center, Boston, Massachusetts, USA
| | - Alvaro Navarro
- Department of Otolaryngology-Head and Neck Surgery, Tulane University, New Orleans, Louisiana, USA
| | - Lily Trinh
- Department of Otolaryngology-Head and Neck Surgery, Tulane University, New Orleans, Louisiana, USA
| | - Waleed M Abuzeid
- Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology and Endoscopic Skull Base Surgery, University of Washington, Seattle, Washington, USA
| | - Ian M Humphreys
- Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology and Endoscopic Skull Base Surgery, University of Washington, Seattle, Washington, USA
| | - Nadeem A Akbar
- Department of Otorhinolaryngology-Head and Neck Surgery, Division of Rhinology and Skull Base Surgery, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Sharan Shah
- Department of Otorhinolaryngology-Head and Neck Surgery, Division of Rhinology and Skull Base Surgery, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Jivianne T Lee
- Department of Otolaryngology-Head and Neck Surgery, University of California Los Angeles, Los Angeles, California, USA
| | - Tara J Wu
- Department of Otolaryngology-Head and Neck Surgery, University of California Los Angeles, Los Angeles, California, USA
| | - John S Schneider
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri, USA
| | - Edward D McCoul
- Department of Otolaryngology-Head and Neck Surgery, Tulane University, New Orleans, Louisiana, USA.,Department of Otorhinolaryngology and Communication Sciences, Ochsner Clinic Foundation, New Orleans, Louisiana, USA
| |
Collapse
|
32
|
Gonella S, Conti A, Albanesi B, Antal A, Dimonte V, Di Giulio P. Lived experiences of end-of-life communication among nursing home staff: An interpretive phenomenological study. J Adv Nurs 2023; 79:698-710. [PMID: 36447384 DOI: 10.1111/jan.15489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 09/16/2022] [Accepted: 10/19/2022] [Indexed: 12/02/2022]
Abstract
AIMS To explore and understand lived experiences of end-of-life communication among nursing home staff. DESIGN Interpretive phenomenological study. METHODS In-person, semi-structured, in-depth interviews were conducted from May to August 2021 with 21 nursing home staff members involved in end-of-life communication (four managers, four chief nurses, three chief medical officers, three nurses, three psychologists, two occupational therapists, one chief nurse aide and one nurse aide). Data were analysed by van Manen's hermeneutic approach, which uses the lifeworld existentials of spatiality, corporeality, temporality and relationality to guide reflection on the human experience. Data were reported according to the Consolidated Criteria for Reporting Qualitative Research. RESULTS Thirteen categories were identified and framed within the four existentials. Regarding spatiality, end-of-life communication took place in a physical, mental, socio-cultural and professional competence space. With regard to corporeality, interviewees reported difficulties in managing their own feelings and those of family caregivers. For temporality, interviewees reported delays in end-of-life communication due to staffing issues and an increase in urgent and temporary relief admissions to nursing homes. To compensate, they tried to assure that all interactions that did take place were of high quality. Finally, with regard to relationality, interviewees lived end-of-life communication through their relationships with family caregivers and colleagues. The supportive role of colleagues was expressed as teamwork, which helped promote reflexivity about how to tailor communication, manage challenging emotions and situations, set aside time for communication, and prepare family caregivers for death. CONCLUSION End-of-life communication was an all-encompassing experience for nursing home staff. The supportive role of colleagues was stressed across all existentials, suggesting that teamwork is essential in delivering effective communication at the end-of-life. PATIENT OR PUBLIC CONTRIBUTION There was no patient or public contribution to this study, which addresses the experiences of nursing home staff only.
Collapse
Affiliation(s)
- Silvia Gonella
- Department of Public Health and Pediatrics, University of Torino, Torino, Italy.,Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Alessio Conti
- Department of Public Health and Pediatrics, University of Torino, Torino, Italy
| | - Beatrice Albanesi
- Department of Public Health and Pediatrics, University of Torino, Torino, Italy
| | - Alexandra Antal
- Department of Public Health and Pediatrics, University of Torino, Torino, Italy
| | - Valerio Dimonte
- Department of Public Health and Pediatrics, University of Torino, Torino, Italy.,Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Paola Di Giulio
- Department of Public Health and Pediatrics, University of Torino, Torino, Italy
| |
Collapse
|
33
|
Hovey RB. The Daily Grind of Living With Chronic Pain: An Applied Hermeneutic Exploration. Glob Qual Nurs Res 2023; 10:23333936221148591. [PMID: 36644372 PMCID: PMC9834916 DOI: 10.1177/23333936221148591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 12/08/2022] [Accepted: 12/15/2022] [Indexed: 01/11/2023] Open
Abstract
The purpose of this research is to explore the philosophy regarding understanding the complex experience of living with chronic pain. As well, this article addresses a person's suffering as an evolving process of learning to not only manage pain but to learn how to live well through exploring their suffering narrative. A hermeneutical interpretive approach was used to engage participants in this research and to offer a philosophical reinterpretation of living with chronic pain from a humanistic and tacit perspective. This work is offered to invite and extend our discussions about the complexity of living with chronic pain. It can also be understood as a process of rewriting oneself from a lived chaotic state of pain into a new affective historical consciousness. This transition from acute to chronic pain explored through a philosophical context can provide insight into the ways in which patients learn to live well with their condition.
Collapse
Affiliation(s)
- Richard B. Hovey
- McGill University, Montreal, QC,
Canada,Richard B. Hovey, Faculty of Dental
Medicine and Oral Health Sciences, McGill University, 2001 McGill College
Avenue, Suite 500, Montreal, QC H3A 1G1, Canada.
| |
Collapse
|
34
|
Ferstad K, Rykkje L. Understanding the Significance of Listening to Older People's Life Stories in Whole Person Care-An Interview Study of Nurses in Gerontology. SAGE Open Nurs 2023; 9:23779608231164077. [PMID: 36949851 PMCID: PMC10026136 DOI: 10.1177/23779608231164077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 02/27/2023] [Indexed: 03/19/2023] Open
Abstract
Aim: The purpose of this study was to explore the significance of performing a life story interview for gerontological nursing students. Method: The study had a qualitative exploratory design, focusing on hermeneutical understanding using thematic analysis. Seven nurses in older people nursing were interviewed. Findings: Two main themes emerged from the analysis: "Engaging fellowship" and "Understanding the importance of life stories." The participants experienced increased engagement and fellowship with their patients after the life story interview; the change in their perspective was characterized by renewed interest, connection, and recognition of the individual person. The participants also gained a deeper understanding of the significance of listening to an older person's life story narrative, and this was expressed through them gaining an understanding of people's actions, achieving an altered mindset, gaining a greater generational understanding, and integrating a life story focus in their everyday professional life. Conclusion: Knowledge of human life and stories makes older people's situations easier to understand; this insight affects how we as nurses think about others. Seeing each patient as an individual and unique person and being aware of this in daily care is essential for nursing.
Collapse
Affiliation(s)
- Kristin Ferstad
- VID Specialized University, Faculty of Health Studies, Bergen,
Norway
- Kristin Ferstad, VID Specialized
University, Faculty of Health Studies, Bergen, Norway.
| | - Linda Rykkje
- VID Specialized University, Faculty of Health Studies, Bergen,
Norway
| |
Collapse
|
35
|
Nielsen AH, Kvande ME, Angel S. Humanizing and dehumanizing intensive care: Thematic synthesis (HumanIC). J Adv Nurs 2023; 79:385-401. [PMID: 36281216 PMCID: PMC10092106 DOI: 10.1111/jan.15477] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 09/13/2022] [Accepted: 10/12/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Critical illness and the intensive care unit can be a terrifying experience to patients and relatives and they may experience the extreme life-saving measures as dehumanizing. Humanizing intensive care is often described as holism or dignity, but these abstract concepts provide little bodily resonance to what a humanized attitude is in concrete situations. OBJECTIVE To explore what contributes to patients' and relatives' experience of intensive care as humanized or dehumanized. DESIGN Thematic synthesis. MATERIALS Findings from 15 qualitative papers describing patients' and/or relatives' perceptions of humanizing or dehumanizing care. METHODS A systematic literature search of PubMed, CINAHL, Scopus and EMBASE from 1 January 1999 to 20 August 2022 identified 16 qualitative, empirical papers describing patients' and relatives' experiences of humanizing or dehumanizing intensive care, which were assessed using Critical Appraisal Skills Programme Qualitative Checklist, 15 papers were included and analysed using Thematic Synthesis and Ricoeur's model of the text. FINDINGS Intensive care was humanized when patients felt connected with healthcare professionals, with themselves by experiencing safety and well-being and with their loved ones. Intensive care was humanized to relatives when the patient was cared for as a unique person, when they were allowed to stay connected to the patient and when they felt cared for in the critical situation. CONCLUSION Patients and relatives experienced intensive care as humanized when healthcare professionals expressed genuine attention and supported them through their caring actions and when healthcare professionals supported patients' and relatives' opportunities to stay connected in the disrupted situation of critical illness. When healthcare professionals offered a connection to the patients and relatives, this helped them hold on and find meaning. PATIENT OR PUBLIC CONTRIBUTION No patient and public contribution.
Collapse
Affiliation(s)
- Anne Højager Nielsen
- Department of Anesthesiology and Intensive care, Gødstrup Hospital, Herning, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Monica Evelyn Kvande
- Lovisenberg Diaconal University College, Oslo, Norway.,Operation and Intensive Care Unit, University Hospital of North Norway, Tromsø, Norway
| | - Sanne Angel
- Department of Public Health, Nursing, Aarhus University, Aarhus, Denmark
| |
Collapse
|
36
|
Öhlén J, Friberg F. Empirical Phenomenological Inquiry: Guidance in Choosing Between Different Methodologies. Glob Qual Nurs Res 2023; 10:23333936231173566. [PMID: 37215583 PMCID: PMC10196530 DOI: 10.1177/23333936231173566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 03/05/2023] [Accepted: 04/06/2023] [Indexed: 05/24/2023] Open
Abstract
Empirical phenomenological inquiry and analyses are of high relevance and applicability for nursing and health care. Phenomenology has clear roots in philosophy, which needs to be brought into an empirical phenomenological inquiry. However, all study of phenomena and experience does not qualify as phenomenological inquiry. The aim of this article is to provide guidance for how to relate different empirical phenomenological methodologies that are in play in the broader field of healthcare research, and thus support healthcare researchers in navigating between these methodologies. For pedagogical purposes, we present commonalities and differences as related to descriptive and interpretive phenomenological inquiries throughout the research process. The merits and criticisms of empirical phenomenological inquiry are commented on.
Collapse
Affiliation(s)
- Joakim Öhlén
- Institute of Health and Care Sciences and
Centre for Person-Centred Care (GPCC), and Sahlgrenska University Hospital, Palliative
Centre, University of Gothenburg, Gothenburg, Sweden
| | - Febe Friberg
- Faculty of Health Sciences, Stavanger,
University of Stavanger, Norway
| |
Collapse
|
37
|
Corcoran L, Cook K. The philosophy of Hans-Georg Gadamer: An exemplar of the complicated relationship between philosophy and nursing practice. Nurs Inq 2023; 30:e12509. [PMID: 35715885 PMCID: PMC10078372 DOI: 10.1111/nin.12509] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 05/25/2022] [Accepted: 06/02/2022] [Indexed: 01/25/2023]
Abstract
Philosophy has a complicated relationship with nursing practice. Selected concepts from Hans-Georg Gadamer's Truth and Method specifically prejudice, conversation, and language are articulated. An exemplar involving nursing practice at an outpatient clinic for women seeking pre- and postbreast cancer care is offered to explicate these concepts. We considered the fit of Gadamer's philosophy, particularly the concept of conversation, within a public health nursing practice context in home and community settings of the client/family and offered tentative conclusions. To extend the discussion of the relationship between philosophy and nursing practice, we posed questions developed to provide deeper insight into this complicated relationship.
Collapse
Affiliation(s)
- Lynn Corcoran
- Faculty of Health Disciplines, Athabasca University, Athabasca, AB, Canada
| | - Karen Cook
- Faculty of Health Disciplines, Athabasca University, Athabasca, AB, Canada
| |
Collapse
|
38
|
Martí-García C, Fernández-Férez A, Fernández-Sola C, Pérez-Rodríguez R, Esteban-Burgos AA, Hernández-Padilla JM, Granero-Molina J. Patients' experiences and perceptions of dignity in end-of-life care in emergency departments: A qualitative study. J Adv Nurs 2023; 79:269-280. [PMID: 36062865 PMCID: PMC10087743 DOI: 10.1111/jan.15432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 07/16/2022] [Accepted: 08/20/2022] [Indexed: 12/15/2022]
Abstract
AIMS To explore and understand the experiences of patients with advanced illness in relation to dignity during end-of-life care in emergency departments. DESIGN Qualitative study based on Gadamer's hermeneutics. METHODS Between September 2019 and February 2020, 16 in-depth interviews were carried out with advanced illness patients who attended emergency departments. The participants were informed priorly and signed informed consent. The data were analysed using an inductive strategy for finding emerging themes. The Consolidated Criteria for Reporting Qualitative Research was used for writing the study's report. RESULTS In the data analysis process, two main themes emerged that glean the experiences of patients in relation to dignity during end-of-life care in emergency departments. 'Dignity as an individual's attribute' and 'Acting with dignity: Dignity as a behavioural attribute'. CONCLUSION Patient dignity in end-of-life care is centred around the principle of control (of oneself, one's death and one's emotions). The strategies required for patients to preserve their dignity can be somewhat incompatible with the dynamics and objectives of healthcare professionals who work in emergency departments. IMPACT STATEMENT The dignity of patients with advanced illness who attend emergency departments is a relevant issue that merits being addressed from the patients' perspective. Participants have identified that dignity is a way of being and behaving in the face of illness. Emergency departments need to respect end-of-life patients' desires by supporting and accompanying them, avoiding therapeutic obstinacy. We recommend care to be centred on patients' well-being, to respect their autonomy and decision-making processes, and to allow prompt referrals to palliative care services. PATIENT OR PUBLIC CONTRIBUTION Managers from the Emergency Departments participated in the study design and patients' recruitment. Patients' relatives were informed about the study's aim, and they contributed to the development of the interview protocol.
Collapse
Affiliation(s)
| | | | - Cayetano Fernández-Sola
- Department of Nursing Science, Physiotherapy and Medicine, University of Almería, Spain.,Faculty of Health Sciences, Universidad Autónoma de Chile, Santiago, Chile
| | | | | | | | - José Granero-Molina
- Department of Nursing Science, Physiotherapy and Medicine, University of Almería, Spain.,Faculty of Health Sciences, Universidad Autónoma de Chile, Santiago, Chile
| |
Collapse
|
39
|
Montreuil M, Gendron‐Cloutier L, Laberge‐Perrault E, Piché G, Genest C, Rassy J, Malboeuf‐Hurtubise C, Gilbert E, Bogossian A, Camden C, Mastine T, Barbo G. Children and adolescents' mental health during the COVID-19 pandemic: A qualitative study of their experiences. J Child Adolesc Psychiatr Nurs 2022; 36:65-74. [PMID: 36566357 PMCID: PMC9880751 DOI: 10.1111/jcap.12404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 10/03/2022] [Accepted: 12/04/2022] [Indexed: 12/26/2022]
Abstract
TOPIC Public health measures implemented in response to the COVID-19 pandemic severely disrupted children and adolescents' (C&A) lives, affecting their sense of structure, predictability, and security. PURPOSE To examine C&A' experiences during the COVID-19 pandemic to better understand how this context and its associated public health measures affected them and their mental health, and to identify helpful coping strategies. SOURCES USED The study was guided by a participatory hermeneutic framework. Semistructured interviews were conducted with 25 C&A aged 6-17 years during the first and second pandemic waves. Participants' interviews were analyzed following a narrative synthesis approach, through which C&A' experiences were contrasted and contextualized to highlight relevant themes. CONCLUSIONS Participants described a distinct pattern related to their mental health as the pandemic unfolded, which followed the severity of the pandemic in the province. Negative repercussions on their mental health were linked to the loss of social activities, imposed public health measures, transition to online learning, and challenges with family relationships. Certain youth shared positive societal and moral reflections triggered by the pandemic context. Coping strategies reported include: having a variety of hobbies; expressing their emotions; and accessing financial and material resources. This study highlights the importance of supporting C&A' mental health during crisis situations such as a pandemic. Their perspectives are vital for clinical practice and policy improvement, particularly to find means for social engagement while maintaining safety.
Collapse
Affiliation(s)
- Marjorie Montreuil
- Ingram School of NursingMcGill UniversityMontrealQuebecCanada,Centre de recherche de l'Institut universitaire en santé mentale de MontréalMontréalQuebecCanada,Centre de recherche de l'Institut universitaire en santé mentale DouglasMontréalQuebecCanada
| | | | | | - Geneviève Piché
- Université du Québec en Outaouais, Campus de Saint‐JérômeGatineauQuebecCanada
| | - Christine Genest
- Centre d'étude sur le trauma du Centre de recherche de l'Institut universitaire en santé mentale de Montréal et le Centre de recherche et d'intervention sur le suicide, les enjeux éthiques et pratiques de fin de vie, Faculté des sciences infirmièresUniversité de MontréalMontrealQuebecCanada
| | - Jessica Rassy
- École des sciences infirmièresUniversité de Sherbrooke, Campus de LongueuilLongueuilQuebecCanada
| | | | - Elsa Gilbert
- Département des sciences de la santéUniversité du Québec à RimouskiRimouskiQuebecCanada
| | - Aline Bogossian
- École de travail socialUniversité de MontréalMontrealQuebecCanada
| | - Chantal Camden
- School of Physical and Occupational TherapySherbrooke UniversitySherbrookeQuebecCanada
| | | | - Geneveave Barbo
- Ingram School of NursingMcGill UniversityMontrealQuebecCanada
| |
Collapse
|
40
|
Pastor-López Á, Ventura-Puertos PE, Hernández-Ascanio J, Cantón-Habas V, Martínez-Angulo P, Rich-Ruiz M. Emotional Universe of Nurse Case Managers Regarding Care for Elderly at Risk in Spain: A Hermeneutical Study. Int J Environ Res Public Health 2022; 19:16445. [PMID: 36554326 PMCID: PMC9778613 DOI: 10.3390/ijerph192416445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/03/2022] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
The role of nurse case managers (NCM) involves a rarely visible emotional labor, even more when their role focuses on the care of elders at risk (EAR). Motivated by the lack of qualitative research on the emotional universe of NCM, this study explores the emotional universe (EU) of NCM regarding the care they provide to EAR in primary health care as well as the reasons that generate these emotions. An interpretative-phenomenological approach was implemented in southern Spain, with a purposive sampling that included nurses playing the NCM role for at least three years. Data collection was conducted in two periods (between September 2019 and July 2022). The primary collection tool was the semi-structured individual interview, with starting categories based on Bisquerra's EU taxonomy. The analysis followed Ricoeur's considerations, using the Nvivo software. In the NCM's EU, the recognition of the social phenomena stands out, with an open feeling of empathy regarding the desire of the EAR to continue living at home. However, there was also helplessness, resignation, disappointment, and frustration when EAR rejected their proposals. Furthermore, the system's limitations aroused compassion in the NCM and made them go beyond the limits of their role. This EU requires that their role be valued more, and higher responsiveness must be enforced to improve EAR care.
Collapse
Affiliation(s)
- Ángeles Pastor-López
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba (UCO), Hospital Universitario Reina Sofía (HURS), 14004 Córdoba, Spain
- Distrito Sanitario Córdoba-Guadalquivir, Servicio Andaluz de Salud (SAS), 14011 Córdoba, Spain
| | - Pedro E. Ventura-Puertos
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba (UCO), Hospital Universitario Reina Sofía (HURS), 14004 Córdoba, Spain
- Interdisciplinary Research Group in Discourse Analysis (HUM380), Universidad de Córdoba (UCO), 14071 Córdoba, Spain
| | - José Hernández-Ascanio
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba (UCO), Hospital Universitario Reina Sofía (HURS), 14004 Córdoba, Spain
| | - Vanesa Cantón-Habas
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba (UCO), Hospital Universitario Reina Sofía (HURS), 14004 Córdoba, Spain
| | - Pablo Martínez-Angulo
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba (UCO), Hospital Universitario Reina Sofía (HURS), 14004 Córdoba, Spain
- Interdisciplinary Research Group in Discourse Analysis (HUM380), Universidad de Córdoba (UCO), 14071 Córdoba, Spain
| | - Manuel Rich-Ruiz
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba (UCO), Hospital Universitario Reina Sofía (HURS), 14004 Córdoba, Spain
- Ciber Fragility and Healthy Aging (CIBERFES), 28029 Madrid, Spain
- Nursing and Healthcare Research Unit (Investén-isciii), Instituto de Salud Carlos III, 28029 Madrid, Spain
| |
Collapse
|
41
|
Khalili-Mahani N, Mischkowski D, Hovey RB. Editorial: Qualitative pain research: Capturing and integrating cultural, social and linguistic data. Front Pain Res (Lausanne) 2022; 3:1082044. [PMID: 36506270 PMCID: PMC9731110 DOI: 10.3389/fpain.2022.1082044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 11/07/2022] [Indexed: 11/25/2022] Open
Affiliation(s)
- Najmeh Khalili-Mahani
- McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, Montreal, QC, Canada
- Culture and Mental Health Research Unit, Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
- PERFORM Centre, Concordia University, Montreal, QC, Canada
| | | | - Richard B. Hovey
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC, Canada
| |
Collapse
|
42
|
Ayres JRDCM. Health and human rights: Contributions of hermeneutics to a necessary dialogue. Glob Public Health 2022; 17:3098-3108. [PMID: 35980803 DOI: 10.1080/17441692.2022.2113814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The relationship between health and human rights has gained growing importance, whether in activist agendas or in governments strategies to face the challenging scenarios of global public health. However, there are important gaps to be filled so that the articulation between these two fields develops its full potential, and the question of knowledge plays a key role in this regard. This study aims at examining the possibilities and challenges of integrating a human rights perspective into the construction and validation of health knowledge, based on the contribution of authors from various theoretical traditions that have discussed the so-called 'hermeneutic turn' in contemporary philosophy and science. The thesis developed is that recognizing the place of hermeneutics in human rationality and its consequences for understanding various forms of knowledge and their respective practical meanings is a fundamental step towards an effective articulation between the fields of health and human rights. I argue that the hermeneutic rescue of the value of practical reason can enhance emancipatory reconstructions in the exercise of cognitive-instrumental rationality in the field of health.
Collapse
|
43
|
Gustafsson L, Asztalos Morell I, Johansson C, De S. Informal caregiving from the perspectives of older people living alone in India. Int J Older People Nurs 2022; 17:e12468. [PMID: 35466547 PMCID: PMC9787525 DOI: 10.1111/opn.12468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 03/22/2022] [Accepted: 03/28/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND The cultural and social norms in India stipulate that family and preferably children of the older person, provide the support and care that is needed. In recent years, we have witnessed an overall upsurge in interest in informal care from all countries in the developed world considering their ageing populations. The older people living alone group is, especially interesting in this matter, since it seems to deviate from the expectations of extended family living. OBJECTIVE The aim was to describe older persons' experiences of informal care when living alone in India. METHODS The study has a hermeneutic design, analysing interviews of older persons living alone in India. RESULTS Findings revealed informal care as the thematic patterns: Informal care as a fundamental human responsibility, an obligation and thereby a way to act in 'common sense'. It was a way of 'paying-back' care that they had received from others in their life history, motivated by governmental care was not presented as an option. Informal care also created safety by the provision of alert and actionable care by loved ones, including spatial safety. Most of the informants experienced themselves as informal caregivers assisting others in need even if they themselves were old and fragile. Providing self care was also seen as a part of informal care conducted by capable and worthy persons. They also pointed out their own obligation to seek informal care and even to listen to the suggestions of younger generations regarding the type and scope of care. CONCLUSIONS/IMPLICATIONS FOR PRACTICE Informal care in India is not only dependent on having children who ensure that you receive the care you need. Extended family, neighbours and friends feel a basic human obligation to care for the older people in their environment. This responsibility is deeply rooted even within the older people who become fragile in old age.
Collapse
Affiliation(s)
| | - Ildikó Asztalos Morell
- School of Health, Care and Social WelfareMälardalen UniversityEskilstunaSweden,Department of Urban and Rural DevelopmentSwedish University of AgricultureUppsalaSweden
| | - Carl Johansson
- School of Health, Care and Social WelfareMälardalen UniversityEskilstunaSweden
| | - Santa De
- College of NursingBharati Vidyapeeth UniversityPune, MaharashtraIndia
| |
Collapse
|
44
|
Härle K, Börjeson S, Hallböök O, Myrelid P, Thylèn I. Putting life on hold: A longitudinal phenomenological-hermeneutic study of living with [or close to someone with] an enterocutaneous fistula before and after reconstructive surgery. J Clin Nurs 2022. [PMID: 36209357 DOI: 10.1111/jocn.16551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 07/08/2022] [Accepted: 08/05/2022] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES Illuminate meanings of living with [or close to someone with] an enterocutaneous fistula before and after reconstructive surgery. BACKGROUND Enterocutaneous fistula is a serious condition affecting the well-being and social life of both patients and families, sometimes for several years. DESIGN A longitudinal qualitative design. METHODS Patients and families (n = 14) were followed with dyadic interviews at three occasions, conducted 2017-2020. The interviews were analysed with a phenomenological-hermeneutic approach. COREQ guidelines were followed. RESULT Living with an enterocutaneous fistula was explained as life being put on hold, while living in a bubble for an uncertain time. This bubble meant facing an unpredictable and restricted life where the dyads were forced to take control over the situation despite being vulnerable inside, striving to resume normality. The patients dealt with never-ending symptoms such as leakage from the fistula, pain and fatigue, while the family supported with practical matters and just being close. Dependency on intravenous fluids resulted in social isolation, which caused mode swings and depressiveness. In this situation, healthcare professionals often became a substitute for other interactions, but the lack of understanding about the dyads' situation, affected their trust in the healthcare. Despite all, they still had belief in the future, the patients having higher expectations than the family. CONCLUSIONS Living with an enterocutaneous fistula meant a daily life struggling with many limitations. This implies that the transition was associated with difficulties and the dyads strived to accept their situation. RELEVANCE TO CLINICAL PRACTICE The findings indicate that these patients must be cared for with a multidisciplinary approach. A person-centred health plan could impact on the dyads' feeling of control and thereby making them less dependent on healthcare. Every patient should have their own contact nurse and be offered psychological support. NO PATIENT OR PUBLIC CONTRIBUTION Not applicable due to the current method.
Collapse
Affiliation(s)
- Karolina Härle
- Department of Surgery, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Sussanne Börjeson
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Olof Hallböök
- Department of Surgery, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Pär Myrelid
- Department of Surgery, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Ingela Thylèn
- Department of Cardiology, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| |
Collapse
|
45
|
Mohebbi Z, Dehbozorgi R, Setoodeh G, Momennasab M, Heydari N, Shaygan M. Lived Experience of Iranian Family Caregivers of Tubercular Patients: A Qualitative Study. Invest Educ Enferm 2022; 40:e02. [PMID: 36867775 PMCID: PMC10017139 DOI: 10.17533/udea.iee.v40n3e02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 10/03/2022] [Indexed: 06/18/2023]
Abstract
OBJECTIVES To investigate the lived experience of family caregivers of persons with tuberculosis. METHODS In this study, the method of hermeneutic phenomenology. Data were collected through online in-depth semi-structured interviews with nine family caregivers of TB patients. The obtained data were thematically analyzed to explain the concept of home care for TB patients through van Manen's 6-step methodology. RESULTS After the thematic analysis, three main themes of caregivers' mental distresses, quality care stasis, and facilitated care were obtained from 944 primary codes and 11 categories. CONCLUSIONS Family caregivers of these patients suffer from mental distress. This issue affects the quality and ease of caregiving for these patients. Therefore, policymakers of this area should pay attention to the family caregivers of these patients and attempt to provide support; they should try to improve their quality of life.
Collapse
Affiliation(s)
- Zinat Mohebbi
- School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Raziye Dehbozorgi
- Nursing and Midwifery School, Isfahan University of Medical Sciences, Isfahan, Iran. Ph.D. Candidate.
| | - Giti Setoodeh
- School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Marzieh Momennasab
- School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Naval Heydari
- School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Shaygan
- School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
46
|
Abstract
Migrants, that is people who experience forced displacement or move based on being lesbian, gay, bisexual, trans, two-spirit, queer, and intersex (LGBTQI+), experience increased trauma and stigma when compared to heterosexual and cisgender people. The aim of this paper is to highlight LGBTQI+ migrants' experiences of health and social care encounters in Canada. Gadamerian hermeneutics and an intersectionality lens was used to understand LGBTQI+ migrants' experiences. A total of 16 semi-structured individual interviews were conducted with LGBTQI+ migrants. Themes of stigma and discrimination were identified as (1) "I never went back": Stigma as an exclusionary experience, (2) "Is [your country of birth] really that bad": Fear, safety, and cultural stigma, and (3) "The circle … is not going to fix my life": LGBTQI+ migrants' call for affirming care. Results suggest that health and social care practices are stigmatizing and discriminatory which negatively impacts LGBTQI+ migrant mental health. Salient practices for promoting mental health included affirming LGBTQI+ identities and orientations through health and social care practices that are culturally safe as well as trauma and violence informed.
Collapse
Affiliation(s)
- Roya Haghiri-Vijeh
- School of Community and Health Studies, 58403Centennial College, Scarborough, ON, Canada
| | - Nancy Clark
- Faculty of Human and Social Development, School of Nursing, 175083University of Victoria, Victoria, BC, Canada
| |
Collapse
|
47
|
Vigouroux M, Amja K, Bertolizio G, Ingelmo P, Hovey R. Reflecting back to move forward: Lessons learned about COVID-19 safety protocols from pediatric anesthesiologists. Paediatr Anaesth 2022; 32:1138-1143. [PMID: 35852924 PMCID: PMC9349821 DOI: 10.1111/pan.14531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 06/17/2022] [Accepted: 07/14/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND The COVID-19 pandemic brought about the immediate need for enhanced safety protocols in health care centers. These protocols had to evolve as knowledge and understanding of the disease quickly broadened. AIMS Through this study, the researchers aimed to understand the experiences of pediatric anesthesiologists at the Montreal Children's Hospital and the Shriners' Hospital Canada as they navigated the first wave of COVID-19 at their institutions. METHODS Nine participants from the Montreal Children's Hospital and the Shriners' Hospital were interviewed. Interviews were recorded, transcribed verbatim, and then analyzed using an applied philosophical hermeneutics approach. FINDINGS Participants expressed their wish for simple and easy-to-apply protocols while recognizing the challenge of keeping up with evolving knowledge on the disease and its transmission. They pointed to some limitations and unintended consequences of the safety protocols and the system-wide flaws that the COVID-19 pandemic helped bring to light. They described their frustrations with some aspects of the safety protocols, which they at times felt could be more efficient or better suited for their daily practice. CONCLUSIONS The findings of this study highlighted the importance of listening to and empowering anesthesiology staff working in the field during crises, the implications of shifting from patient-centered care to community-centered care, and the fine line between sharing as much emerging information as possible and overwhelming staff with information.
Collapse
Affiliation(s)
- Marie Vigouroux
- Faculty of Dental Medicine and Oral Health SciencesMcGill UniversityMontrealQuebecCanada,Edwards Family Interdisciplinary Centre for Complex PainMontreal Children's HospitalMontrealQuebecCanada
| | - Kristina Amja
- Faculty of Dental Medicine and Oral Health SciencesMcGill UniversityMontrealQuebecCanada
| | - Gianluca Bertolizio
- Department of AnesthesiaMontreal Children's HospitalMontrealQuebecCanada,Department of Anesthesia, Faculty of Medicine and Health SciencesMcGill UniversityMontrealQuebecCanada
| | - Pablo Ingelmo
- Edwards Family Interdisciplinary Centre for Complex PainMontreal Children's HospitalMontrealQuebecCanada,Department of Anesthesia, Faculty of Medicine and Health SciencesMcGill UniversityMontrealQuebecCanada
| | - Richard Hovey
- Faculty of Dental Medicine and Oral Health SciencesMcGill UniversityMontrealQuebecCanada
| |
Collapse
|
48
|
Rehnsfeldt A, Slettebø Å, Lohne V, Sæteren B, Lindwall L, Heggestad AKT, Råholm MB, Høy B, Caspari S, Nåden D. Dignity in relationships and existence in nursing homes' cultures. Nurs Ethics 2022; 29:1761-1772. [PMID: 35801831 PMCID: PMC9667089 DOI: 10.1177/09697330211041739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Introduction: Expressions of dignity as a clinical phenomenon in nursing homes as expressed
by caregivers were investigated. A coherence could be detected between the
concepts and phenomena of existence and dignity in relationships and caring
culture as a context. A caring culture is interpreted by caregivers as the
meaning-making of what is accepted or not in the ward culture. Background: The rationale for the connection between existence and dignity in
relationships and caring culture is that suffering is a part of existence,
as well as compassion in relieving suffering, and ontological
interdependency. Aim: To describe different expressions of dignity in relationships and existence
in context of caring cultures from the perspective of the caregivers. Research design: The methodology and method are hermeneutic. The method used was to merge the
theoretical preunderstanding as one horizon of understanding with empirical
data. Participants and research context: Focus group interviews with caregivers in nursing homes. Ethical considerations: The principles of the Helsinki Declaration have been followed to, for
example, preserve self-determination, integrity, dignity, confidentiality
and privacy of the research persons. Findings: Data interpretation resulted in four themes: Encountering existential needs
that promote dignity in a caring culture; To amplify dignity in
relationships by the creative art of caring in a caring culture; Violation
of dignity by ignorance or neglect in a non-caring culture and The ethic of
words and appropriated ground values in a caring culture. Discussion: Dignity-promoting acts of caring, or dignity-depriving acts of non-caring are
adequate to see from the perspective of dignity in relationships and
existence and the caring culture. Conclusions: Dignity in relationships seems to touch the innermost existential life, as
the existential life is dependent on confirmation from others.
Collapse
Affiliation(s)
- Arne Rehnsfeldt
- Western Norway University of Applied Sciences, Faculty of Health and Social Sciences, Department of Health and Caring sciences
| | - Åshild Slettebø
- University of Agder, Faculty of Health and Sport Sciences, Department of Health and Nursing Sciences, Norway
| | | | - Berit Sæteren
- Oslo Metropolitan University, Faculty of Health Sciences, Department of Nursing and Health Promotion, Norway
| | - Lillemor Lindwall
- Karlstad Univeristy, Faculty of Health, Science and Technology, Department of Health Sciences
| | | | - Maj-Britt Råholm
- Western Norway University of Applied Sciences, Faculty of Health and Social Sciences, Department of Health and Caring sciences
| | | | | | - Dagfinn Nåden
- Oslo Metropolitan University, Faculty of Health Sciences, Department of Nursing and Health Promotion, Norway
| |
Collapse
|
49
|
van Oorsouw R, Klooster E, Koenders N, Van Der Wees PJ, Van Den Boogaard M, Oerlemans AJM. Longing for homelikeness: A hermeneutic phenomenological analysis of patients' lived experiences in recovery from COVID-19-associated intensive care unit acquired weakness. J Adv Nurs 2022; 78:3358-3370. [PMID: 35765746 PMCID: PMC9349706 DOI: 10.1111/jan.15338] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 05/11/2022] [Accepted: 06/06/2022] [Indexed: 12/01/2022]
Abstract
Aims To explore lived experiences of patients recovering from COVID‐19‐associated intensive care unit acquired weakness and to provide phenomenological descriptions of their recovery. Design A qualitative study following hermeneutic phenomenology. Methods Through purposeful sampling, 13 participants with COVID‐19‐associated intensive care unit acquired weakness were recruited with diversity in age, sex, duration of hospitalization and severity of muscle weakness. Semi‐structured in‐depth interviews were conducted from 4 to 8 months after hospital discharge, between July 2020 and January 2021. Interviews were transcribed verbatim and analysed using hermeneutic phenomenological analysis. Results The analysis yielded five themes: ‘waking up in alienation’, ‘valuing human contact in isolation’, ‘making progress by being challenged’, ‘coming home but still recovering’ and ‘finding a new balance’. The phenomenological descriptions reflect a recovery process that does not follow a linear build‐up, but comes with moments of success, setbacks, trying new steps and breakthrough moments of achieving mobilizing milestones. Conclusion Recovery from COVID‐19‐associated intensive care unit acquired weakness starts from a situation of alienation. Patients long for familiarity, for security and for recognition. Patients want to return to the familiar situation, back to the old, balanced, bodily self. It seems possible for patients to feel homelike again, not only by changing their outer circumstances but also by changing the understanding of themselves and finding a new balance in the altered situation. Impact Muscle weakness impacts many different aspects of ICU recovery in critically ill patients with COVID‐19‐associated intensive care unit acquired weakness. Their narratives can help nurses and other healthcare professionals, both inside and outside of the intensive care unit, to empathize with patient experiences. When healthcare professionals connect to the lifeworld of patients, they will start to act and communicate differently. These insights could lead to optimized care delivery and meeting patients' needs in this pandemic or a possible next.
Collapse
Affiliation(s)
- Roel van Oorsouw
- Department of Rehabilitation, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Emily Klooster
- Deventer Hospital, Department of Rehabilitation, Deventer, The Netherlands.,Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, The Netherlands
| | - Niek Koenders
- Department of Rehabilitation, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Philip J Van Der Wees
- Department of Rehabilitation, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands.,Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, The Netherlands
| | - Mark Van Den Boogaard
- Department of Intensive Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Anke J M Oerlemans
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, The Netherlands
| |
Collapse
|
50
|
Stikholmen T, Nåden D, Alvsvåg H. Dignity at stake in educational relations - The significance of confirmation. Nurs Ethics 2022; 29:1600-1614. [PMID: 35723264 DOI: 10.1177/09697330221089083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION It is a goal in nursing education to promote students' dignity and facilitate this core value. Students' experience of dignity is shaped by the student-supervisor relationship. Literature shows limited knowledge about how nursing students experience their own dignity during education. RESEARCH AIM The aim of the study is to develop an understanding of how nursing students experience their own dignity in relation to supervisors, and what significance these experiences have in education. RESEARCH DESIGN Gadamer's philosophical hermeneutics was chosen as the approach, and narratives and qualitative interviews were conducted. The interpretation process was inspired by Fleming, Gaidys and Robbs. PARTICIPANTS AND RESEARCH CONTEXT Nineteen nursing students in the final year of their education were included in the study. They represented six different campuses at three different educational institutions. The qualitative interviews took place at the educational institutions. ETHICAL CONSIDERATIONS The research recommendations of the Declaration of Helsinki were followed. Access to the students was given by the educational institutions. All interested students signed a continuous informed consent. FINDINGS Students' dignity was at stake in encounters with supervisors during education. Decisive for experience of dignity was the supervisor's ability to confirm the student through acknowledgment, reassurance and seeing them as individuals. Experienced dignity had a crucial impact on students' life courage and their ability to be present. DISCUSSION The discussion emphasizes the vulnerable dignity of students, the importance of confirmation and the significance perceived dignity has. CONCLUSION Students' experiences tilted between perceived dignity and offense, and placed students' dignity in a vulnerable position. Crucial for perceived dignity was the confirmation the students received from their supervisors. Perceived dignity gave the students courage and increased their ability to be present, which provided better opportunities for learning and development.
Collapse
Affiliation(s)
- Tone Stikholmen
- Centre of Diaconia and Professional Practice, 155312VID Specialized University, Bergen, Norway
| | - Dagfinn Nåden
- Faculty of Health Sciences, Department of Nursing and Health Promotion, 60499OsloMet, Oslo, Norway
| | - Herdis Alvsvåg
- Faculty of Health Studies, 155312VID Specialized University, Bergen, Norway
| |
Collapse
|