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  • 1.
    Arman, M.
    et al.
    Karolinska Institutet, Huddinge, Sweden.
    Ranheim, Albertine
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Rydenlund, K.
    Forensic Psychiatric Regional Clinic, Vadstena, Sweden.
    Rytterström, P.
    Linköping University, Norrköping, Sweden.
    Rehnsfeldt, A.
    Stord/Haugesund University College, Stord, Norway.
    The Nordic Tradition of Caring Science: The Works of Three Theorists2015In: Nursing Science Quarterly, ISSN 0894-3184, E-ISSN 1552-7409, Vol. 28, no 4, p. 288-296Article in journal (Refereed)
    Abstract [en]

    The Nordic tradition of caring science has had a significant influence on healthcare research, healthcare education and clinical development in the Nordic countries from 1990 to the present. Theoretical contributions from the professors and scientists Katie Eriksson, Kari Martinsen and Karin Dahlberg form the basis for this paper. The tradition has established a paradigm of ethics, ontology and epistemology for the caring science domain. Short introductions present the scientific background of Eriksson, Martinsen, and Dahlberg, and show how interpretive teamwork has led to the formation of an intertwining of the essential qualities of the theories. The synthesis emphasizes caring science as a human science, and views caring as a natural phenomenon where the patient’s world, vulnerability, health, and suffering are primary. In the art and act of caring, relationships and dialogue are essential; they provide parameters where caring becomes visible in its absence.

  • 2.
    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: IPDJ International Practice Development Journal, 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
  • 3.
    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.

  • 4.
    Ranheim, Albertine
    Linköpings universitet, Hälsa, Aktivitet, Vård (HAV).
    Expanding Caring: Theory and Practice intertwined in municipal elderly care2011Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The Swedish Agency for Higher Education evaluated in 2007 the nursing programs at Swedish Universities, and confirmed that several programs lacked definition of the main subject of the discipline;- namely caring- and/or nursing. The caring science disciplines showed indications of increasing signs of fragmentation, in that sub-disciplines were evolving. There is a unique foundation of theoretical knowledge that is specific for the caring professions grounded in caring theory and philosophy. For some reason the theoretical foundation and contexture of providing care seems to fade off with time in clinical practice, as well as an explicated theory-practice gap; that theory does not go along with clinical practice. An assumption in this thesis is that caring theory somehow seems to evaporate; as nurses become clinically active- caring theory does not seem to be much reflected upon.The overall aim was to investigate into the meaning of caring to nurses in municipal elderly care, and into their explicit and implicit understanding of caring theory in their daily practice.The theoretical perspective was caring science, while the epistemological frame was of a phenomenological hermeneutical life world approach. Data was gathered by interviews with nurses working in elderly care and analyzed to grasp the structure of the phenomenon of caring in theory and practice. The thesis comprises four studies of which three empirical was consolidated with a Jean Watson’s specific caring theory, ending up in a better understanding of the approach of caring in nursing and the role of theory in practice.

    The findings of the studies show that the lived experience of caring as narrated by the participating nurses comprises both implicit and explicit theoretical foundation to existential caring theory. The explicit use of theory or certain theoretical affiliation was not obvious; rather what may be theoretical inputs was expressed as the importance of being present and the necessity of having a health perspective in caring. By illuminating caring and concepts from caring theory, the meaning of caring in their professional lived experience, the primary intention or choice of working as nurses became apparent again. There seems to be different perspectives related to caring theory, but as the empirical findings shows, there is a consensus behind what caring is, both in theory and in practice. As a result from the analysis the aim of caring itself may be more salient and focused if based on existential phenomenological caring concepts and theory, as this corresponds with the nurses understanding of holistic intentional caring with a health perspective.

    A gap exists, but is more related to organizational restrictions such as role constraints and time pressure than to the meaning of caring in theory and practice.

    Mediating care is a concept that embraces the implications of all the outcome concepts of the analysis and it has the possibility of being the expression of immanent and transcendent dimensions in caring. Mediating care represents the expression of our understanding of life, our values and norms. It is given expression through the insights into, and the ways we connect to one another, our ability as carers (nurses) to reach out to another in his or her being, as well the understanding of ones own being in caring. Theoretical and practical reflection and cultivation of clinical sensibility has the opportunity of inspiring for an expanded caring consciousness, manifested in the mediation of care.

  • 5.
    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: IPDJ International Practice Dvelopment Journal, 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

     

  • 6.
    Ranheim, Albertine
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Dahlberg, Karin
    Linneuniversitetet Växjö.
    Expanded awareness as a way to meet the challenges in care that is economically driven and focused on illness- a nordic perspective2012In: Aporia: The Nursing Journal, ISSN 1918-1345, Vol. 4, no 4, p. 20--24Article in journal (Refereed)
    Abstract [en]

    In Sweden as well as in many other countries, nursing and caring science exist in a health care context that is characterised by increasing reliance on the economics of diagnoses and measureable symptoms. This presents a challenge for caring science to defend person - and lifeworld-centred care. Nursing as a caring science must make clear its position in modern health care. The objective of this paper is to show how health oriented nursing, grounded in caring science, advocates expanded nursing care. The paper revisits the relationship between nursing and caring science, specifically the insights from new caring science research that emphasises carers’ capacity for expanded awareness. In addition, the ever-present question of evidence is addressed.

  • 7.
    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.

  • 8.
    Ranheim, Albertine
    et al.
    Linköpings universitet, Hälsa, Aktivitet, Vård (HAV).
    Kärner, Anita
    Linköpings universitet, Hälsa, Aktivitet, Vård (HAV).
    Arman, Maria
    Karolinska Institute, Stockholm. Sweden.
    Rehnsfeldt, Arne Wilhelm
    Karolinska Institute, Stockholm, Sweden.
    Berterö, Carina
    Linköpings universitet, Omvårdnad.
    Embodied reflection in practice-Touching the core of caring2010In: International Journal of Nursing Practice, ISSN 1322-7114, E-ISSN 1440-172X, Vol. 16, no 3, p. 241-247Article in journal (Refereed)
    Abstract [en]

    A study was performed with the aim of clarifying the integration of the caring act of touch with reflection on caring theory. Seven participant nurses in elderly care volunteered as coresearchers and performed a caring act called Rhythmical Embrocation, together with reflective dialogues on caring theory. The project lasted for 6 months and at the end qualitative interviews with participants were used to evaluate the study. The findings showed an opening of awareness, embodied moments of presence and an extended ability to act creatively in caring. In this study, the movement between theory and practice was the integration of the caring act with reflection on basic caring concepts. Implications for praxis development are that implementation and reflection by teams over certain caring acts might open the door to an expanded view of ones own caring ability that in the long run will benefit the patient.

  • 9.
    Ranheim, Albertine
    et al.
    Linköpings universitet, Hälsa, Aktivitet, Vård (HAV).
    Kärner, Anita
    Linköpings universitet, Hälsa, Aktivitet, Vård (HAV).
    Berterö, Carina
    Linköpings universitet, Omvårdnad.
    Caring Theory and Practice - Entering a Simultaneous Concept Analysis2012In: Nursing Forum, ISSN 0029-6473, Vol. 47, no 2, p. 78-90Article in journal (Refereed)
    Abstract [en]

    PROBLEM.  To better understand the approach of caring in nursing and the role of theory in practice, we wanted to consolidate the caring theory of Watson with the empirical findings from the three studies performed to reveal nurses' caring intentions and their lived experience of reflecting caring theory in practice.

    METHOD.  Through a simultaneous concept analysis of nine concepts, caring science theory was consolidated with the findings of the three empirical studies to reveal the dynamics of caring theory and caring practice.

    FINDINGS AND CONCLUSION.  These nine concepts were found to be interrelated with the advanced concept of mediating care, which emphasizes that mediating care calls for an authenticity of being and ability—an ability to be present to self and others in the dynamism of openness and frames of thought.

  • 10.
    Ranheim, Albertine
    et al.
    Linköpings universitet, Hälsa, Aktivitet, Vård (HAV).
    Kärner, Anita
    Linköpings universitet, Hälsa, Aktivitet, Vård (HAV).
    Berterö, Carina
    Linköpings universitet, Omvårdnad.
    Caring Theory and Practice: entering a Simultaneous Concept AnalysisManuscript (preprint) (Other academic)
    Abstract [en]

    To better understand the approach of caring in nursing and the role of theory in practice, we wanted to consolidate the empirical findings from three studies performed to reveal nurses’ caring intentions, their lived experience of reflecting caring theory in practice, with caring theory by Watson (1979, 2008).

    Through a simultaneous concept analysis (SCA) of nine concepts, caring theory was consolidated with the findings of three empirical studies – to reveal the dynamics of caring theory and practice. In conclusion these nine concepts interrelate to the advanced concept mediating care. Mediating care is the visualized outcome or evidence for the intertwining of theory and practice in caring.

  • 11.
    Ranheim, Albertine
    et al.
    Linköpings universitet, Hälsa, Aktivitet, Vård (HAV).
    Kärner, Anita
    Linköpings universitet, Hälsa, Aktivitet, Vård (HAV).
    Berterö, Carina
    Linköpings universitet, Omvårdnad.
    Challenge for theory and practice in elderly care: intertwining forcesManuscript (preprint) (Other academic)
    Abstract [en]

    Aim: Investigating 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.

    Background: 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.

    Method: 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.

    Findings: A detachment to caring theory was enunciated, but when describing their caring intentions, the nurses’ 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.

    Conclusion: 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 organisation become one intertwining force.

  • 12.
    Ranheim, Albertine
    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.
    Harder, Maria
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Facilitating young children's participation in health care situations2014Conference paper (Refereed)
    Abstract [en]

    Facilitating young children’s participation in health care situations Background An initiative was given to perform a collaborative research project with health practices in Sörmland on facilitating young children’s participation in health care situations. Departing from workshop with healthcare professionals conveyed that it is an ambiguous challenge to be in care situations with children since each situation depends on its participants; the child, the parents and the professionals. These findings were used in reflective forums to integrate theory and practice to broaden the professionals’ awareness of the child’s perspective in care situations. The project is inspired by a clinical application research (CAR) design, where scientifically trained researchers work with health care professionals, building a team to exchange experiences related to data collection, interpretations and the applicability of the results.

    The use of research involves a process of learning as well as engaging beliefs and actions, and these questions are foundational for the practice of clinical care. Such approach aims at facilitating the use of research in clinical practice, to reduce the eventual gap between theory and its practical application.

     

    The overall aim of the project is to facilitate young children’s participation in their health care situations Method and Material The CAR design involves understanding, interpretation and application. This means reflecting on care situations and being confronted with assumptions from theoretical perspectives as well as training an openness and awareness in caring encounters. The team work is in a continued progress and will last during 2014. The data analysis will then proceed.

    Result :Some preliminary result will be presented about the process and outcome of the clinical application research Clinical implications: This study may contribute to the stock of knowledge regarding the implementation of an interactive communicative device with the purpose to facilitate young children’s participation in their health care situations.

  • 13.
    Söderbäck, Maja
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Harder, Maria
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Ranheim, Albertine
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Being in care situations with young children presents ambigious challenges.2015In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 0, no 0, p. 1-6Article in journal (Refereed)
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