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  • 1.
    Arman, Maria
    et al.
    Mälardalen University, School of Health, Care and Social Welfare. Karolinska Institutet, Sweden.
    Alvenäng, Annika
    Alanus University, Stuttgart, Sweden.
    El Madani, Nadia
    Vidarkliniken, Sweden.
    Hammarqvist, Ann- Sofie
    Vidarkliniken, Sweden.
    Ranheim, Albertine
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Caregiving for existential wellbeing: existential literacy. A clinical study in an anthroposophic healthcare context2013In: International Practice Development Journal, E-ISSN 2046-9292, Vol. 3, no 1, p. 1-15Article in journal (Refereed)
    Abstract [en]

    Background and context: The occurrence of existential caregiving as a natural element of healthcare is the focus of this research. According to the literature, there is a lack of understanding of this issue, from a theoretical as well as a clinical point of view. In this design ‘existential’ and ‘spiritual’ are seen as synonymous and without religious association. Existential questions are regarded as questions about life, death, meaning, love, vulnerability, responsibility and dependence. The context for the project is an integrated anthroposophic hospital that offers rehabilitation for patients with cancer.

    Aims and objectives

    : With the support of an anthroposophic and caring scientific view of human beings, and by using concrete examples, the aim is to develop and deepen an understanding of existential care for patients in life-decisive phases in the care and rehabilitation of cancer. Clinical application research was used in cooperation with academic researchers and clinically active colleagues. Eleven clinicians from varying professions and two researchers collaborated over the course of two years. The data used came from 65 case reports of significant care situations experienced by the team members. A joint interpretive qualitative analysis led to the formulation of the findings.

    Conclusions

    : Existential caregiving in practice requires an ‘existential literacy’, using the metaphor of human life as a text or a book whose contents are legible only for the one versed in the language. In order to gain a complete understanding of caregiving, an ability to read a suffering human’s language and decipher its meaning is essential. The patient’s narrative might open up a caregiver’s awareness in a single illuminating moment. An authentic and listening attitude together with an active restriction of one’s own suppositions increase the possibility of providing existential care. Compassion and professional judgement function as the caregiving compass and ‘lexica’ for existential care.

    Implications for practice:

    1. An understanding of existential caregiving moments implies a developed insight into and sensitivity for the patient’s signs and needs
    2. Existential caring moments have countless variations, while bodily and intimate situations are sometimes found to be an opening to spontaneous, trustful interactions. Such moments could be learning moments if reflected and shared
    3. For training in the ability to ‘read the patient’, clinical reflections in groups where existential literacy is collectively sought are an option
    4. Clinical application research can allow caring scientific theory and healthcare research to be implemented in practice immediately, which may enhance quality of care and ultimately benefit the patient
  • 2.
    Gustafsson, Christine
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Gustafsson, Lena-Karin
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Snellman, Ingrid
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Trust leading to hope - the signification of meaningful encounters in Swedish healthcare. The narratives of patients, relatives and healthcare staff2013In: International Practice Development Journal, E-ISSN 2046-9292, Vol. 3, no 1, p. 1-13Article in journal (Refereed)
    Abstract [en]

    Background: The fact that patients and relatives experience poor healthcare encounters is evident in the number of complaints to patients’ advisory committees, and from studies and statistics. Looking at ‘the other side of the coin’, research into good caring encounters experienced as meaningful encounters in healthcare is scarce.

    Aim: To illuminate the signification of meaningful encounters in healthcare. 124 narratives from patients, relatives and healthcare staff regarding experiences of meaningful encounters in Swedish healthcare were analysed using a phenomenological hermeneutic research method.

    Conclusions: The results indicate that a meaningful encounter means gratefulness, is founded on trust, cooperation and courage, and results in self-trust through wellbeing, increased understanding and life-changing insights. The encounters have given insight into, and increased understanding of, the patient’s own life, the families’ lives, and/or healthcare professionals’ lives. With this, and awareness of the importance and power of meaningful encounters, healthcare staff might use a meaningful encounter as a powerful instrument in caring.

    Implications for practice:

    • For patients and relatives, trust derived from meaningful encounters in healthcare leads to self-trust
    • Caring within healthcare consisting of meaningful encounters, ‘the other side of the coin’ gives important knowledge that could facilitate improvements in healthcare staff’s encounters with patients and relatives, and also enrichment in their own professional development
    • Increased understanding and awareness of the power of meaningful encounters can be discussed in terms of patient safety

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  • 3.
    Ranheim, Albertine
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Arman, Maria
    Karolinska Institutet.
    Methodological considerations and experiences in clinical application research design2014In: International Practice Development Journal, E-ISSN 2046-9292, Vol. 4, no 1, p. 1-20Article in journal (Refereed)
    Abstract [en]

    Background: Strengthening the relationship between research and clinical practice, and improving the use of research in healthcare are challenging areas that need creative solutions. Clinical application research is a design based on Gadamer’s idea that understanding always involves interpretation and application.

    Aims and objectives

    This study aims to assess from a methodological viewpoint a project in which two researchers cooperated with clinical healthcare workers over three years.

    Methods

    Interviews with the participating clinicians on a ward for rehabilitative cancer care. Inspired by Gadamerian epistemology, a interpretive analysis was performed on the transcripts of three focus group meetings.

    Findings

    Taking part in the project demonstrated to the participants the value of systematic and analytical scientific work in the acquisition of new knowledge and wider insights. Participants were inspired to investigate taking theoretical assumptions from caring science into practical clinical work. They described an expanded reflective awareness of caring work in terms of their observational abilities. Everyday challenges were clarified and deeper aspects of caring emerged; tacit knowledge became expressed and verbalised.

    Conclusions

    The participants developed a scientific approach to their clinical caregiving knowledge, as well as an increased awareness of their profession. If an organisation is interested in improving its results, and its patients’ experience of health and wellbeing, this study recommends that it devote time and resources to strengthening the relation between research and clinical practice. Clinical application research is a structure that can help achieve this.

    Implications for practice

    1. Clinical application research creates the possibility to develop deeper awareness of procedures that are taken for granted

    2. Clinical experts are given opportunities to develop a scientific approach to practical clinical care

    3. Researchers in caring sciences are given a response to their theory from its application in practice

     

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