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  • 1.
    Bastholm Rahmner, Pia
    et al.
    Stockholm County Council.
    Tomson, Göran
    Karolinska Institutet.
    Rosenqvist, Urban
    Uppsala universitet, Hälso- och sjukvårdsforskning.
    Gustafsson, Lars L
    Karolinska Institutet.
    Holmström, Inger
    Uppsala universitet, Hälso- och sjukvårdsforskning.
    "Limit work to here and now": A focus group study on how emergency physicians view their work in relation to patients' drug treatment2008In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 3, no 3, p. 155-164Article in journal (Refereed)
    Abstract [en]

    Patients come to the emergency department (ED) with complex medication and some patients present symptoms of adverse drug effects. Drug treatment is a complex process for physicians to handle. The aim of this study was to explore how a group of ED physicians view their work in relation to patients’ drug treatment. Three semi-structured focus group discussions with 12 physicians in an ED in Sweden were conducted and analysed thematically. The core theme was ‘‘limit work to here and now’’. Three descriptive themes were identified in relation to the main theme; (1) focussing to cope with work; (2) decision making on limited patient-specific information; and (3) actively seeking learning moments. The findings show that the physicians actively seek learning moments in work. Signing their own notes in the computerized medical record is a way of getting feedback on the treatment they have initiated and it was seen as a large part of their clinical education. If we want to support the physicians with new technology for safer drug treatment, such as a computerized drug prescribing support system, the support system should be adapted to the different learning styles and needs.

  • 2.
    Berglund, Mia
    et al.
    Högskolan i Skövde, Institutionen för vård och natur.
    Westin, Lars
    Högskolan i Skövde, Institutionen för vård och natur.
    Svanström, Rune
    Högskolan i Skövde, Institutionen för vård och natur.
    Johansson Sundler, Annelie
    Högskolan i Skövde, Institutionen för vård och natur.
    Suffering caused by care - Patients' experiences from hospital settings2012In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 7, p. Article number 18688-Article in journal (Refereed)
    Abstract [en]

    Suffering and well-being are significant aspects of human existence; in particular, suffering and well-being are important aspects of patients’ experiences following diseases. Increased knowledge about existential dimensions of illness and healthcare experiences may be needed in order to improve care and reduce unnecessary suffering. Therefore, the aim of this paper is to illuminate the phenomenon of suffering experienced in relation to healthcare needs among patients in hospital settings in Sweden. In this study, we used a reflective lifeworld approach. The data were analysed with a focus on meanings. The results describe the essential meaning of the phenomenon of suffering in relation to healthcare needs. The patients were suffering during care-giving when they felt distrusted or mistreated and when their perspective on illness and health was overlooked. Suffering was found to arise due to healthcare actions that neglected a holistic and patient-centred approach to care. Unfortunately, healthcare experiences that cause patients to suffer seem to be something one needs to endure without being critical. The phenomenon can be described as having four constituents: to be mistreated; to struggle for one’s healthcare needs and autonomy; to feel powerless; and to feel fragmented and objectified. The study concludes that there are problems associated with patients experiencing suffering at the hands of healthcare providers, even if this suffering may not have been caused deliberately to the patient. Consequently, conscious improvements are needed to lessen the suffering caused by care-giving, as are strategies that promote more patient-centred care and patient participation.

  • 3.
    Fagerberg, I.
    et al.
    Department of Health Care Sciences, Ersta Sköndal University College, Stockholm, Sweden.
    Engström, Gabriella
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Care of the old: A matter of ethics, organization and relationships2012In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 7, article id 9684Article in journal (Refereed)
    Abstract [en]

    The world stands on the threshold of a demographic revolution called global ageing. According to the World Health Organization (WHO), the population aged 60 and over is expected to increase from today's 650 million to an estimated 2 billion by 2050. Alongside demographic changes, dramatic changes can also be observed in older people's services. The shift has resulted in reduced government spending on caring for ill and frail older people in health care. Today, many governments have developed strategies to keep older people living well in their private home for as long as possible and have replaced long-term care institutions with residential homes. The aim of this study was to illuminate the meaning of caring for older people as experienced by health care students and professionals working in this field. Interviews were carried out with 17 women and one man, aged 21-65 years; six were Registered Nurses (RN), six were Enrolled Nurses (EN) and six were nursing students. The interviews were analyzed with a phenomenological hermeneutical approach and provided three themes and eight sub-themes: Ethical moral self with sub-themes "meeting the needs of the old", "pliability towards the old", and "difficulties in meeting aggressiveness"; Organizational and co-workers ethical moral actions with sub-themes, "co-workers who are offensive", and "supportive and non-supportive leaders": The relation with the old persons and their relatives with sub-themes "fellowship and closeness in the relation", "uncertainty and fear in the relation", and, "demands from the older persons' close relatives".

  • 4.
    Hakimnia, Roya
    et al.
    Uppsala universitet, Sweden.
    Holmström, Inger K.
    Uppsala universitet, Sweden.
    Carlsson, Marianne
    Uppsala universitet, Sweden.
    Höglund, Anna T
    Uppsala universitet, Sweden.
    Exploring the communication between telenurse and caller – A critical discourse analysis.2014In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, ISSN 1748-2623,, Vol. 24, no 9, article id 24255Article in journal (Refereed)
    Abstract [en]

    Background: Telenursing is an expanding service in most Western societies. Sweden is a front-line country, with all of its 21 counties connected to Swedish Healthcare Direct (SHD) 1177. The intention of the service is twofold: to make health care more efficient, while also making it more accessible and safe for patients. Previous research has shown, however, that the service is not used equitably. Gender, age, socio-economic, and ethnicity differences have been reported as determining factors for the use of the service and the advice given.

    Aim: The aim of the study was to explore the communication between telenurses and callers in authentic calls to SHD 1177.

    Methodology: A qualitative method, using critical discourse analysis (CDA), was chosen. The approach was deductive, that is, the analysis was made in view of a predetermined framework of theory. Twenty calls were strategically chosen and included in the study.

    Results: The CDA resulted in five types of calls, namely a gatekeeping call, a gendered call, a call marked by impersonal traits, a call with voices of the life world, and finally a counter discourse call. The dominating patterns in the calls were of gatekeeping and biomedical character. Patterns of the societal gender order were found, in that representations of the reluctant male caller and the ideal female caller were identified, but also a call representing a counter discourse. The service seemed difficult to use for patients with low language proficiency.

    Conclusion: Telenursing could potentially challenge inequalities in health care. However, the discourse of telenursing is dialectically related to neoliberal ideology and the ideology of medicine. It is also situated in a gendered context of ideal femininity and hegemonic masculinity. Through better awareness of gender biases and the callers’ different resources for making themselves heard, the communication between telenurse and caller might become more equal and thereby better suitable for all callers.

  • 5.
    Harder, Maria
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Ranheim, A.
    Department of Nursing, Institute of Neurobiology, Care and Society Karolinska Instiutet, Stockholm, Sweden.
    Health care professionals’ perspective on children’s participation in health care situations: encounters in mutuality and alienation2018In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 13, no 1, article id 1555421Article in journal (Refereed)
    Abstract [en]

    Purpose: Encounters between health care professionals, parents and children in health care services for children are complex as these encounters involve the various perspective and understanding of each person involved. The aim of the study is to describe health care professionals’ understanding of significant encounters with children and parents to uncover the meaning of participation. Method: A qualitative descriptive design was applied. The health care professionals’ narratives (n = 35) of their significant encounters with children were interpreted from the perspective of participation. A phenomenological-hermeneutical approach was used in the analysis. Results: The findings show children’s participation as a dynamic movement in mutuality and alienation which can vary within a situation or between different situations involving the same persons. The movement can occur in mutuality and or in alienation depending on what or towards whom the persons direct themselves. Understanding participation as a movement in health care situations is useful in supporting children’s opportunities to participate from their own perspective and deal with health care examinations. Conclusion: The outcome of a situation can never be predicted. Still, professionals can be aware of their actions in encounters with children.

  • 6.
    Hjelmblink, Finn
    et al.
    Uppsala universitet, Uppsala, Sweden.
    Bernsten, Cecilia B
    Uppsala universitet, Uppsala, Sweden.
    Uvhagen, Håkan
    Uppsala universitet, Uppsala, Sweden.
    Kunkel, Stefan
    Uppsala universitet, Uppsala, Sweden.
    Holmström, Inger
    Uppsala universitet, Uppsala, Sweden.
    Understanding the meaning of rehabilitation to an aphasic patient through phenomenological analysis - a case study2007In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 2, no 2, p. 93-100Article in journal (Refereed)
    Abstract [en]

    Stroke patients with aphasia commonly suffer from distress related to their language deficit. They are often unable to express what they experience during their rehabilitation. Hence, the aim of this study was to reveal the meaning of rehabilitation to an aphasic person. With an approach based on the philosophy of Husserl and Merleau-Ponty, two open-ended interviews were analysed through the Empirical Phenomenological Psychological (EPP) method. The essential structure of the meaning of rehabilitation to the informant was that he lived as being responsible in a dichotomised situation. The informant had to adapt his behaviour, thereby destroying his chances of normal interactions; he was supposed to train in a goal-oriented way and believe in recuperation, but at the same time, he had to prepare himself and his next of kin for a failure. The defined impairment of aphasia misled both the informant and health care professionals to focus only language therapy, hence leaving the informant unsupported in other important aspects of the rehabilitation.

  • 7.
    Holmberg, Mats
    et al.
    Sömlands County Council, Ambulance Service Department.
    Fagerberg, Ingegerd
    Ersta Sköndal Högskola, Institutionen för vårdvetenskap.
    The encounter with the unknown: Nurses lived experiences of their responsibility for the care of the patient in the Swedish ambulance service2010In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 5, no 2, p. 1-9Article in journal (Refereed)
    Abstract [en]

    Registered nurses (RNs) have, according to the Swedish National Board of Health and Welfare, the overall responsibility for the medical care in the ambulance care setting. Bringing RNs into the ambulance service are judged, according to earlier studies, to lead to a degree of professionalism with a higher quality of medical care. Implicitly in earlier studies, the work in the ambulance service involves interpersonal skills. The aim of this study was to describe RNs' experiences of being responsible for the care of the patient in the Swedish ambulance service. A reflective lifeworld approach within the perspective of caring science was used. Five RNs with at least five years experience from care in the ambulance care setting were interviewed. The findings show that the essence of the phenomenon is to prepare and create conditions for care and to accomplish care close to the patient. Three meaning constituents emerged in the descriptions: prepare and create conditions for the nursing care, to be there for the patient and significant others and create comfort for the patient and significant others. The responsibility is a complex phenomenon, with a caring perspective, emerging from the encounter with the unique human being.

  • 8.
    Larsson, Jan
    et al.
    Uppsala Academic Hospital, Uppsala, Sweden.
    Holmström, Inger
    Department of Public Health and Caring Sciences, Health Services Research, Uppsala, Sweden.
    Phenomenographic or phenomenological analysis: does it matter?: Examples from a study on anaesthesiologists' work2007In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 2, no 1, p. 55-64Article in journal (Refereed)
    Abstract [en]

    Phenomenography is a research approach developed from an educational framework. However, practised in other areas this research approach can be misunderstood as seems to be the case in some reports on allegedly phenomenographic studies. In this article, the authors show how the phenomenographic approach differs from a phenomenological one, using as an example an interview study on anaesthesiologists' understanding of work. Having performed both a phenomenographic and a phenomenological analysis of the same transcripts, the researchers compared the results from the two approaches. The result of the phenomenographic study was four ways of understanding work: (a) monitoring and controlling the patient's vital functions; (b) guiding the patient safely through the operation; (c) serving patients, other doctors and nurses; (d) leading the operating theatre and team. The phenomenological analysis showed the essence of being an anaesthesiologist: Carrying the responsibility for the patient's vital functions; always being alert, watching carefully over the patient's body, ready to act whenever the patient's life is in danger, however difficult the circumstances. The authors discuss the differences between the two research approaches, stressing the value of phenomenographic studies in educational settings as well as its limited value in research on patients' experiences of illness.

  • 9.
    Larsson, Margaretha
    et al.
    Högskolan i Skövde, Institutionen för vård och natur.
    Sundler, Annelie Johansson
    Högskolan i Skövde, Institutionen för vård och natur.
    Ekebergh, Margaretha
    Linnæus University, Växjö, Sweden.
    The influence of living conditions on adolescent girls' health2012In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 7, p. article number: 19059-Article in journal (Refereed)
    Abstract [en]

    Adolescence is described by the Swedish National Board of Health and Welfare as the healthiest period in life. However, adolescent girls differ in that they self-report that their health decreases with age. The aim of this hermeneutical study was to describe the meaning of living conditions in relation to adolescent girls' health. Guided by principles of reflective lifeworld research, 15 interviews with adolescent girls were analysed. The result section consists of four narratives with their existential interpretations illustrating different ways of approaching living conditions and their meaning for health and wellbeing. The narratives are: Approaching everyday life in a balanced way-feeling harmonious; approaching everyday life with ambiguity-feeling confused; approaching everyday life as an intellectual project-striving for control; approaching everyday life as a struggle-feeling forlorn. In addition, a comprehensive understanding was developed by using the lifeworld dimensions: lived body, lived room, lived time, and lived relations. These dimensions may deepen the understanding of important parts of those living conditions which are meaningful for the girls' health and well-being. By using the dimensions, complex living conditions have been explored and the meaning of different parts clarified. The girls' thoughts and feelings are often ambiguous and sometimes contradictory, depending on the situation. The health of adolescent girls needs to be understood against the background of their experiences of living conditions. One way to support their health and well-being seems to be to supply them with forums where they can talk about their living conditions.

  • 10.
    Lövenmark, Annica
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Summer Meranius, Martina
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Marmstål Hammar, Lena
    That mr. Alzheimer… you never know what he’s up to, but what about me? A discourse analysis of how Swedish spouse caregivers can make their subject positions understandable and meaningful2018In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 13, no 1, p. 1748-2631, article id ZQHW 1554025Article in journal (Refereed)
    Abstract [en]

    The spouses of people suffering from dementia are commonly first-in-line caregivers. This canhave a considerable effect on their own lives, health and marriages. Several studies havefocused on spouses’experiences, but very few have focused in any depth on their descrip-tions of themselves as subjects. Therefore, the aim of this study is to describe how spousecaregivers can express themselves when living with and caring for their partners withdementia. The study has a qualitative approach with a discourse analysis design and usesanalytical tools such as rhetoric, subject positions and categorization. The results reveal threesubject positions: as an actor, as a parent and as a survivor. The results show that as spousesstruggle with external and internal clashes as subjects, they therefore need to develop copingstrategies. They also experience pronounced loneliness and a risk to their own health. There isthus a need to support these spouses as individuals in their differing and changing needs.

  • 11.
    Lööf, Helena
    et al.
    Sophiahemmet Högskola, Sweden.
    Johansson, Unn-Britt
    Sophiahemmet Högskola, Sweden.
    Welin Henriksson, Elisabet
    Karolinska Institutet, Stockholm, Sweden.
    Lindblad, Staffan
    Karolinska University Hospital, Stockholm, Sweden.
    Bullington, Jennifer
    Karolinska Institutet, Stockholm, Sweden.
    Body awareness in persons diagnosed with rheumatoid arthritis2014In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 9, article id A63Article in journal (Refereed)
    Abstract [en]

    Living with rheumatoid arthritis (RA) poses physiological and psychological demands on a person. RA is a autoimmune disease that can cause pain, disability, and suffering. The ability to notice bodily inner sensations and stimuli (body awareness, BA) is described in the literature in ways that could have either a positive or a negative impact on a person's health. The concept of BA is complex and a thorough understanding is needed about what BA means from the patient's perspective. This study was therefore conducted to acquire greater insight into this phenomenon. The study is grounded in a phenomenological life-world perspective. Eighteen narrative interviews were conducted in patients (age range 23–78 years) with RA. The interviews were analyzed using the Empirical Phenomenological Psychological method. General characteristics were found running through all 18 interviews, indicating that the disease resulted in a higher degree of negatively toned BA. BA was either a reactive process of searching or controlling after disease-related symptoms or a reactive process triggered by emotions. BA was an active process of taking an inventory of abilities. All participants had the ability to shift focus from BA to the outside world. Four typologies were identified: “A reactive process on symptoms,” “A reactive process on emotional triggers,” “An active process of taking an inventory of abilities,” and “A shifting from BA to the outside world.” In conclusion, because BA can be both positively and negatively toned, health care professionals must have a good understanding of when BA is positive and when it is negative in relation to the patient. RA had caused a higher degree of negatively toned BA. Thus, the ability to shift attention from BA to activity in the outside world could sometimes be beneficial for the patient's general health.

  • 12.
    Manasatchakun, Pornpun
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Boromarajonani College of Nursing Udon Thani, Udon Thani, Thailand .
    Chotiga, Pleumjit
    Boromarajonani Coll Nursing Chiang Mai, Chiang Mai, Thailand.
    Roxberg, Åsa
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. School of Health and Welfare, Halmstad University, Halmstad, Sweden; VID Specialized University, Bergen, Norway .
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Healthy ageing in Isan-Thai culture-A phenomenographic study based on older persons' lived experiences2016In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 11, article id 29463Article in journal (Refereed)
    Abstract [sv]

    Healthy ageing is a concept that concerns older persons' quality of life and is a key factor in promoting well-being. The older population in Thailand is growing. Isan (a region of north-eastern Thailand) has been reported as having one of the most rapidly increasing older populations in the country. In order to care for and promote the health of older people, healthcare providers should understand how healthy ageing is perceived by this target group. Although healthy ageing has been studied in different contexts as well as perspectives, no studies have previously focused on older persons' experiences of healthy ageing from a lifeworld perspective in Isan-Thai. Therefore, the aim of this study is to describe older persons' qualitatively different conceptions of healthy ageing in Isan-Thai culture. A phenomenographic approach with an epistemological base in lifeworld theory was used to disclose the various ways to conceptualize healthy ageing. Individual, qualitative interviews were conducted with 17 people aged 60 and above who live in Isan-Thai. The findings of this study revealed three categories of descriptions: "being independent in dependence,'' "being at peace,'' and "being a valuable person.'' This study also found family members, friends, healthcare providers, and religion important to healthy ageing in the Isan-Thai culture. Understanding how older people conceptualize healthy ageing is valuable for healthcare providers. They can apply these findings regarding healthy ageing in their fieldwork when caring for older people.

  • 13.
    Martinsson, Gunilla
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Fagerberg, Ingegerd
    Ersta Sköndal Högskola.
    Lindholm, Christina
    Karolinska Institutet.
    Wiklund Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare.
    Struggling for existence: - Life situation experiences of older persons with mental disorders2012In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 7, no Art. nr. 18422Article in journal (Refereed)
    Abstract [en]

    Older persons with mental disorders represent a vulnerable group of people with extensive and complex needs. The older population is rapidly increasing worldwide and, as a result of deinstitutionalization in mental health care, older persons are remaining at home to a greater extent. Although they constitute a large proportion of the population, older persons with mental disorders have been neglected in research as well as in care organizations. As there is little previous knowledge concerning older persons’ experiences of their own situations, this study aimed to illuminate the meaning of the life situation as experienced by older persons with mental disorders (excluding dementia disorders). Interviews were conducted with seven older persons and the text was analyzed using a phenomenological hermeneutical research method, inspired by the philosophy of Paul Ricoeur. ‘‘Struggling for existence’’ emerged as a main theme in the older persons’ narratives, understood as a loss of dignity of identity and involving being troubled and powerless as well as yearning for respect. The older persons fought to master their existence and to be seen for who they are. The study highlights the importance for caregivers, both formal and informal, to avoid focusing on the diagnoses and rather acknowledge the older persons and their lifeworld, be present in the relation and help them rebuild their dignity of identity. This study brings a new understanding about older persons with mental disorders that may help reduce stigma and contribute to planning future mental health care

  • 14.
    Martinsson, Gunilla
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Wiklund Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare.
    Lindholm, Christina
    Karolinska Institutet.
    Fagerberg, Ingegerd
    Ersta Sköndal Högskola.
    Being altruistically egoistic:  Nursing aides’ experiences of caring for older persons with mental disorders2011In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 6, no 4, p. 7530-Article in journal (Refereed)
    Abstract [en]

    Older persons with mental disorders, excluding dementia disorders, constitute a vulnerable group of people. With the future international increase in the older population, mental disorders will increase as well, thus entailing new challenges for their caregivers. These older persons often remain in their own homes, and in Sweden they are cared for by nursing aides. With little previous research, an increased workload and facing new strenuous situations, it is important to make use of the knowledge the nursing aides possess and to deepen the understanding of their experiences. The study aimed at illuminating the meaning of caring for older persons with mental disorders as experienced by nursing aides in the municipal home help service. Interviews with nine female nursing aides were performed and analysed with a phenomenological hermeneutical research method inspired by the philosophy of Paul Ricoeur. Being altruistically egoistic emerged as a main theme in the nursing aides’ narratives. The nursing aides’ experiences could be interpreted as a movement between being altruistic and egoistic. The findings revealed a continuous distancing by the nursing aides and their struggle to redress the balance between their altruistic and egoistic actions. Caring for these older persons constitutes a complex situation where distancing functions as a recourse to prioritize oneself and to diminish the value of caring. The study suggests that an increased knowledge base on older persons with mental disorders, followed by continuous supervision, is necessary for the nursing aides to improve the quality of the care given

  • 15.
    Nordgren, Lena
    et al.
    Mälardalen University, School of Health, Care and Social Welfare. Vaxjo University, Vaxjo, Sweden .
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare.
    Fagerberg, Ingegerd
    Mälardalen University, School of Health, Care and Social Welfare.
    Safety and understanding: Support as experienced by women living with heart failure in middle age2008In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 3, no 1, p. 39-51Article in journal (Refereed)
    Abstract [en]

    To reformulate and adjust to their life-situation, women living with heart failure (HF) need help and support. However, the actual meaning of the phenomenon of support is not yet well described. The aim of the study was to uncover the meaning of the phenomenon of support as experienced by women living with HF in middle age. A reflective lifeworld approach within the perspective of caring science was used. Six women (aged 33-61 years) were interviewed. The findings show that the essence of support can be understood as safety, depicted by understanding. However, there is tension between what is supportive and what is not, meaning that even though intentions are good, intended support may involve limitations, uncertainties or insecurity. The meaning of support is further illuminated in the following constituents: "knowledge and understanding", "finding balance", "ambiguity of relationships" and "support and formal care - a matter of trust and mistrust". Findings demonstrate the need for carers to find an approach that ensures both good quality medical care and, at the same time, acknowledges the uniqueness of each individual.

  • 16.
    Norfjord Van Zyl, Maria
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Akhavan, Sharareh
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Natl Board Hlth & Welf, Evaluat & Anal Unit, Stockholm, Sweden..
    Tillgren, Per
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Experiences and perceptions about undergoing mammographic screening: a qualitative study involving women from a county in Sweden2018In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 13, no 1, article id 1521256Article in journal (Refereed)
    Abstract [en]

    Purpose:An organized population-based mammographic screening programme aims for an early detection of potential breast abnormalities so that treatment can commence. Continuous participation and a high attendance rate are vital for an effective programme. It is important to understand the underlying reasons for participation in mammographic screening, should there be factors that are amendable within reason and could be adjusted. Therefore, the invited women are valuable sources of information. This study aimed at describing the experiences and perceptions about mammographic screening of women from three municipalities in a Swedish county.Method:Six semi-structured focus-group discussions, each with four to five participants, were held. Content analysis was then conducted.Results:The screening procedure, such as staff professionalism, was covered. Other people's opinions and the woman's own understanding affected the women's decisions on whether or not to undergo the procedure. Structural conditions, such as travel time and financial issues, were sources of concern. However, the offer to perform mammographic screening was perceived with gratitude.Conclusions:Structural conditions, risk and time perceptions, the screening procedure, attitudes towards undergoing it and appreciation of its benefit may influence the women's continuous willingness to be screened, which in turn may affect public and individual health.

  • 17.
    Peilot, Birgitta
    et al.
    Univ Gothenburg, Sahlgrenska Univ Hosp, Dept Mol & Clin Med, Multidisciplinary Pain Ctr,Inst Med,Sahlgrenska A, Gothenburg, Sweden.
    Andrell, Paulin
    Univ Gothenburg, Sahlgrenska Univ Hosp, Dept Mol & Clin Med, Multidisciplinary Pain Ctr,Inst Med,Sahlgrenska A, Gothenburg, Sweden.
    Samuelsson, Anita
    Ctr Hlth, Landvetter, Sweden.
    Mannheimer, Clas
    Ctr Hlth, Landvetter, Sweden.
    Frodi, Ann
    Univ Wisconsin, Rochester, NY USA.
    Sundler, Annelie J.
    Mälardalen University, School of Health, Care and Social Welfare. Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Univ Skovde, Sch Hlth & Educ, Skovde, Sweden.
    Time to gain trust and change-Experiences of attachment and mindfulness-based cognitive therapy among patients with chronic pain and psychiatric co-morbidity2014In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 9, p. art nr 24420-Article in journal (Refereed)
    Abstract [en]

    The treatment of patients with chronic pain disorders is complex. In the rehabilitation of these patients, coping with chronic pain is seen as important. The aim of this study was to explore the meaning of attachment and mindfulness-based cognitive therapy (CT) among patients with chronic pain and psychiatric co-morbidity. A phenomenological approach within a lifeworld perspective was used. In total, 10 patients were interviewed after completion of 7-to 13-month therapy. The findings reveal that the therapy and the process of interaction with the therapist were meaningful for the patients' well-being and for a better management of pain. During the therapy, the patients were able to initiate a movement of change. Thus, CT with focus on attachment and mindfulness seems to be of value for these patients. The therapy used in this study was adjusted to the patients' special needs, and a trained psychotherapist with a special knowledge of patients with chronic pain might be required.

  • 18.
    Ranheim, Albertine
    Linköpings universitet, Hälsa, Aktivitet, Vård (HAV).
    Caring and its ethical aspects-an empirical philosophical dialogue on caring2009In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 4, no 2, p. 78-85Article in journal (Refereed)
    Abstract [en]

    With a focus on caring ethics, the aim of this study was to see if and how experienced nurses in care for the elderly described caring and whether they included any theoretical basis to their caring acts. Questions that guided the research were: Does ethical caring theory have any relevance in nurses clinical work? How do experienced nurses describe care in general, their intentions and motives in particular? In order to enter into the meanings of caring, a reflective lifeworld research approach based on phenomenology was utilized. Eleven experienced nurses were interviewed and the resulting transcripts were analysed for meaning, The findings revealed caring as a seamless integration of different levels, or embodied moments, of knowledge. In caring that is understood as a practical, aesthetical and ethical field of force, there is room for "being", "becoming" and "doing". Theory and practice can and must intertwine to enable the caring goal of health as well-being. A conclusion that may be drawn from this study is that there is a potential for connecting ethical caring concepts and theories into practical everyday care. Nurses basic intentions for a care-giving profession, as well as hidden/forgotten theory and concepts, are viewed in this study as a possibility of turning from a pre-reflective state to a more conscious level. This study gives new nuances to the understanding that existence affects caring and caring affects existence, and contributes to the more general claim that it now is high time for ethical caring science theory to be visible and make a change in care. Highlighting the experience of existential caring intentionality, and relating the experience to theoretical caring substance, this study may contribute to the development of a more consciously ethical and individualized caring culture.

  • 19.
    Ranheim, Albertine Elisabeth
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Kärner, A.
    Department of Social and Welfare Studies, Faculty of Health Sciences, Linköping University, Norrköping, Sweden.
    Berterö, C.
    Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Eliciting reflections on caring theory in elderly caring practice2011In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 6, no 3, article id 7296Article in journal (Refereed)
    Abstract [en]

    Caring theories are the description and conceptualization of the care that is given in caring practise by nurses and other professional caregivers with the aim of verbalizing and communicating caring phenomena. Intermittently, a theory-practice gap is given expression- that theory does not go along with clinical practice in caring. The aim of this study was an investigation into the possible disparity between theory and practice in caring by analysing nurses' lived experience of the understanding of caring theory in practice in the context of municipal elderly care. Hermeneutical phenomenology was the research approach used to explore the lived experience of caring science theories in caring practice from the perspective of 12 nurses working in municipal care for elderly. The findings shows that the nurses Impulsively described their experience of detachment to caring theory, but when describing their caring intentions, the relationship to theory became apparent, and even confirmed their practice. As such, a seedbed exists for caring theory to be reflected on and cultivated in caring praxis. However, as the nurses describe, the caring theory must be sensitive enough for the nursing practitioners to accept. The gap revealed itself on an organisational level, as the nurses' commission in municipal care did not correspond with their caring intention. We believe it is important to seriously consider what we want to achieve as a caring profession. We have to reflect on our responsibility as culture carriers and knowledge developers.We must make the disparate forces of intention and organization become one intertwining force.

  • 20.
    Roxberg, Åsa
    et al.
    Linnéuniversitetet.
    Dahlberg, Karin
    Linnéuniversitetet.
    Stolt, Carl-Magnus
    Karolinska Institute, Stockholm, Sweden .
    Fridlund, Bengt
    Linnéuniversitetet.
    In the midst of the unthinkable: A phenomenological lifeworld approach to the experiences of suffering and relieved suffering during the tsunami catastrophe, 20042009In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 4, no 1, p. 17-27Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to highlight the instantaneous experience of suffering and relieved suffering that was presented on the Swedish Television (SVT) by those who experienced the tsunami wave in Thailand, 26 December 2004. The selected TV-interviews were watched, transcribed and conducted with an empirical phenomenological analysis. A phenomenological lifeworld approach, inspired by the French philosopher Maurice Merleau-Ponty, was chosen for the theoretical framework. The findings showed three main features: the motion, the stillness and the shift in perspective. The motion comprised both the motion of the wave and the motion it caused the victims in terms of external as well as internal disorder. When the tsunami waves withdrew, it was followed by stillness. The feeling of being unreal was prominent, triggered by lack of information and endless waiting. Another prominent feature was the victims' incapacity to answer "how long" they had suffered before being rescued. The tsunami catastrophe seemed to be a timeless event. Caring for other victims meant a shift in perspective in one's own devastated world to that of another person. The shift between focus and comprehension, contributed to the making of life-saving decisions, for the victims themselves and for other victims. The findings were mainly reflected on from the perspective of the French philosopher Maurice Merleau-Ponty, for example the experience of time as an embedded and lived now. It was also reflected on from the perspective of the German philosopher Karl Jaspers as a limit-experience and as a fulfilment of love. A suggestion for further research is to investigate how suffering and relieved suffering is experienced and encountered when further time has passed. Key words: Tsunami, catastrophe, suffering, relieved suffering, care, phenomenology, lifeworld

  • 21.
    Roxberg, Åsa
    et al.
    Linnéuniversitetet, Sweden.
    Sameby, Jessica
    Linnéuniversitetet, Sweden.
    Brodin, Sandra
    Linnéuniversitetet, Sweden.
    Fridlund, Bengt
    Linnéuniversitetet, Sweden.
    Barbosa da Silva, António
    Ansgar Theological Seminary, Kristiansand, Norway.
    Out of the wave: The meaning of suffering and relief from suffering as described in autobiographies by survivors of the 2004 Indian Ocean tsunami2010In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 5, no 3, p. 1-12Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore the meaning of suffering and relief from suffering as described in autobiographies by tourists who experienced the tsunami on 26 December 2004 and lost loved ones. A lifeworld approach, inspired by the French philosopher Merleau-Ponty's phenomenology of perception, was chosen for the theoretical framework. This catastrophe totally changed the survivors' world within a moment. In this new world, there were three main phases: the power of remaining focused, a life of despair, and the unbearable becoming bearable. Life turns into a matter of making the unbearable bearable. Such challenging experiences are discussed in terms of the philosophy of Weil, Jaspers, and Merleau-Ponty. The survivors of the tsunami catastrophe were facing a boundary situation and "le malheur," the unthinkable misfortune. Even at this lowest level of misfortune, joy is possible to experience. This is part of the survivors' ambivalent experiences of their lifeworld. In this world of the uttermost despair there are also rays of hope, joy, and new life possibilities.

  • 22.
    Salzmann-Erikson, Martin
    et al.
    Oslo University.
    Eriksson, Henrik
    Mälardalen University, School of Health, Care and Social Welfare.
    Torrenting values, feelings, and thoughts: Cyber nursing and virtual self-care in a breast augmentation forum2011In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 6, no 4Article in journal (Refereed)
    Abstract [en]

    Earlier research shows that breast augmentation is positively correlated with positive psychological states. The aim of this study was to explore the shared values, feelings, and thoughts within the culture of breast enlargement among women visiting Internet-based forums when considering and/or undergoing esthetic plastic surgery. The study used a netnographic method for gathering and analyzing data. The findings show that the women used the Internet forum to provide emotional support to other women. Through electronic postings, they cared for and nursed each others' anxiety and feelings throughout the whole process. Apart from the process, another central issue was that the women's relationships were frequently discussed; specifically their relationship to themselves, their environment, and with the surgeons. The findings suggest that Internet forums represent a channel through which posters can share values, feelings, and thoughts from the position of an agent of action as well as from a position as the object of action. These dual positions and the medium endow the women with a virtual nursing competence that would otherwise be unavailable. By introducing the concept of torrenting as a means of sharing important self-care information, the authors provide a concept that can be further explored in relation to post modern self-care strategies within contemporary nursing theories and practice

  • 23.
    Sellin, Linda
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Kumlin, Tomas
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Malardalen Univ, Sch Hlth Care & Social Welf, Box 883, S-72123 Vasteras, Sweden..
    Wallsten, Tuula
    Uppsala Univ, Cty Hosp, Clin Res Ctr, Vasteras, Sweden..
    Wiklund Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. UiT Archt Univ Norway, Dept Hlth & Care Sci, Campus Narvik, Narvik, Norway.
    To be present, share and nurture: a lifeworld phenomenological study of relatives' participation in the suicidal person's recovery2017In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 12, article id 1287985Article in journal (Refereed)
    Abstract [en]

    In today's health care, participation is acknowledged as important. However, there is limited research on how relatives of patients at risk of suicide experience their opportunities to participate in care during periods when their close ones are subject to inpatient care. The aim of this study was to describe the phenomenon of participation, as experienced by relatives of persons who are subject to inpatient psychiatric care due to a risk of suicide. The study was conducted through a reflective lifeworld research (RLR) approach, based on phenomenological philosophy. Eight relatives of patients receiving care from professionals in a psychiatric specialist health care context in Sweden participated in phenomenon-oriented interviews. Data were analysed to elucidate a meaning structure of the phenomenon. The findings show that the phenomenon of participation was more associated with patients' recovery processes than with the caring process, and means "being actively involved in a process in which the person regains the desire to live". The meaning of participation is further described by its meaning constituents: struggling for being able to be present for the person at risk of suicide, being able to share everyday life, and nurturing sources for vitality. These insights into the meaning of participation highlight the importance of allowing supportive relatives to be a part of the patient's life, while the person is cared for in an inpatient hospital setting. Thus, participation enables relatives to be acknowledged as resourceful human beings in the patient's recovery process, and thereby facilitates a sense of being able to manage and share life itself together with the person. This means that mental health nurses need to recognize individual variations of relatives' participation processes, and take on the responsibility of acknowledging relatives' lifeworlds.

  • 24.
    Svanström, R.
    et al.
    University of Skövde.
    Johansson Sundler, Annelie
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Berglund, M.
    University of Skövde.
    Westin, L.
    University of Skövde.
    Suffering caused by care-elderly patients' experiences in community care2013In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 8, no 1Article in journal (Refereed)
    Abstract [en]

    Background: Growing old involves many changes in life and implies an increased risks of illness and different forms of disabilities. Life may change in a radical way when a person gets a disease like dementia or moves to a nursing home due to disabilities or needs. In both cases, it often leads to an increased dependency on care where the patient becomes exposed and vulnerable and thereby at a higher risk for experiencing different forms of suffering. Aim: The aim of this study was to elucidate and gain a deeper understanding of elderly patients' experiences of suffering in relation to community care in nursing homes and home care services. Materials and methods: A lifeworld hermeneutical approach was used. Phenomenological interviews and conversations with an open approach were conducted and analysed with a focus on meanings. Findings: The findings were presented in four main themes; an absence of the other in care, an absence of dialogues, a sense of alienation and a sense of insecurity. The findings in this study revealed that persons who were cared for in nursing homes and home care services sometimes were exposed to an unnecessary suffering. The suffering sometimes was caused by various caring actions, that is, unnecessary suffering. The suffering caused by care that aroused was due to caregiver's inability to be present, to show their face, and truly meet the patient. Conclusion: Suffering from care increased the elderly patients' feelings of insecurity, loneliness, and alienation; this seemed to be the foundation for patients' experiences of being outside a human community. There was a lack of knowledge and understanding about the patient's lifeworld. 

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