Lifeworld perspectives of people with dementia: a meta-aggregation of qualitative studies

OBJECTIVES

This meta-aggregation aims to interpret and synthesize present knowledge on the lifeworld perspectives of people with dementia and develop a model for guidance in clinical practice.

METHOD

The data consist of four meta-syntheses describing different lifeworld perspectives in accordance with van Manen's existentials: lived relations, lived space, lived time and lived body. The meta-aggregation summarizes a range of views expressed by people with dementia in qualitative, interview-based studies, with the aim of generating a reliable model based on the studies' findings.

RESULTS

In total, 88 studies among 1,191 persons with dementia were included. Sixteen areas of focus were found, representing four perspectives: (a) lived relations, consisting of connectedness, independence, equality and competence; (b) lived space, consisting of belonging, meaningfulness, safety and security, and autonomy; (c) lived time, consisting of being rooted in the past, being in the present, viewing the future and being in process; and (d) lived body, consisting of being functional, trustworthy, adaptable and presentable. A model shaped as a tree trunk captures the lifeworld perspectives of people with dementia.

CONCLUSION

Sixteen areas were revealed from this meta-aggregation and form the basis of a model. This model may be used as a guide for health care personnel to ensure the overall lifeworld-perspectives of people with dementia in care for the target group and conduct lifeworld-preserving care with a person-centred approach.

Unexplored Aspects of the Meaning of Living with Chronic Heart Failure: A Phenomenological Study within the Framework of the Model of Interpersonal Relationship between the Nurse and the Person/Family Cared for

The complicated situation experienced by chronic heart failure (CHF) patients affects their entire well-being but clinical practice continues to fail to adequately respond to their demands. The aim of this study was to understand the meaning of living with CHF from the patient's perspective. A hermeneutic phenomenological study was conducted according to Van Manen's phenomenology of practice method. Individual conversational interviews were held with 20 outpatients with CHF. Six main themes emerged from the analysis: (1) Living with CHF involves a profound change in the person; (2) The person living with CHF has to accept their situation; (3) The person with CHF needs to feel that their life is normal and demonstrate it to others; (4) The person with CHF needs to have hope; (5) Having CHF makes the person continuously aware of the possibility of dying; (6) The person with CHF feels that it negatively influences their close environment.

Redefining a 'new normality': A hermeneutic phenomenological study of the experiences of patients with chronic heart failure

AIM

To explore the perception of normality in life experienced by patients with chronic heart failure.

DESIGN

A hermeneutic phenomenological study was conducted.

METHODS

Individual conversational interviews were held with 20 outpatients with chronic heart failure between March 2014-July 2015. Van Manen's phenomenology of practice method was used for data analysis.

RESULTS

From the analysis, four main themes emerged: (a) Accepting my new situation; (b) Experiencing satisfaction with life; (c) Continuing with my family, social and work roles; and (d) Hiding my illness from others.

CONCLUSIONS

The present study makes a novel contribution to understanding the importance of the perception of normality in the lives of patients with chronic heart failure. It was found that patients need to incorporate this health experience into their lives and reach a 'new normal', thus achieving well-being. Several factors were identified that can help promote this perception in their lives; therefore, nursing interventions should be designed to help develop scenarios encouraging this normalization process.

IMPACT

Although the implications of having a sense of normality or experiencing 'normalization' of the illness process in life have been studied in other chronic patient populations, no studies to date have examined how patients with chronic heart failure experience this phenomenon in their lives. For the first time, the results of this research prove that the perception of normality is a key aspect in the experience of living with chronic heart failure.

In search of care strategies for distressed people with communication difficulties and a learning disability in palliative care settings: the lived experiences of registered learning disability nurses and palliative care professionals

Aims

The aim of this study was to gain an in-depth phenomenological understanding of the care strategies used by registered learning disability nurses (RNLDs) and palliative care professionals (PCPs) to identify and respond to the distress of people with communication difficulties and a learning disability (PCDLD) in palliative care settings. The objective was to critically explore the lived experiences of RNLDs and PCPs who care for distressed PCDLD in palliative care settings.

Methods

A single-phase hermeneutic phenomenological study following Van Manen provided the framework for the synthesis and structuring of the hermeneutic phenomenological text. Participants were drawn from learning disability nursing homes, community learning disabilities teams and hospices. Purposive sampling was used, and 13 participants comprising eight RNLDs and five PCPs were interviewed. Data were collected by semi-structured, audio-recorded interviews, field notes and a demographic questionnaire. Hermeneutic data analysis was used. Ethical approval was gained from the University Research Ethics Panel and from individual research locations.

Results

The primary strategies used by the participants to identify and respond to the distress of PCDLD were encapsulated by seven main themes: knowing by building relationships; positivity in successful caring outcomes; humane care; moral duty of care; time to care; comfortable care environment; and future perspectives.

Conclusions

Effective care strategies based on the above-mentioned findings can reduce the dilemma professionals encounter in addressing the distress of PCDLD and enhance their confidence to care.

Women's perspectives toward menopause: A phenomenological study in Iran

This study explores the attitude and feelings toward menopause among Azeri menopausal women using hermeneutic phenomenology based on Van Manen's approach. A total of 18 menopausal women who were attended in urban health centers of Tabriz, Iran, were recruited using a purposive sampling method. Data were gathered through semistructured interviews. Each interview was transcribed verbatim and analyzed simultaneously. Data analysis led to the emergence of five main themes: positive attitude, neutral attitude, negative attitude, positive feelings, and negative feelings. Participants had different feelings and attitude. Acceptance of menopause as a natural process helps women to have a neutral attitude toward menopause.