Background: The healthcare system’s unilateral focus on clock time has given motivation to explore the diversity of time and in particular the impact of time in vulnerable patients. When living with severe incurable disease, the diversity and impact of time become prominent.

Aim: Knowledge on patients’ experiences of time may be helpful both in planning, organizing, preparing and performing treatment and care for patients with short life expectancy. Especially to open up the communication with the patient and his/her relatives, this knowledge is important and therefore of general interest.

Theoretical frame: The philosophical and theoretical approach in this study is phenomenological. Edmund Husserl, the founder of modern phenomenology, has stated that consciousness of time is the most important area in phenomenology. Martin Heidegger, known as a master in phenomenology after Husserl, emphasizes the impact of our relationship to time with respect to being.

Method: An unstructured open-ended in-depth interview has been used with support of a theme guide reflecting different aspects of time. The data consist of 26 interviews from 23 participants receiving palliative care. The study was carried out from April 2009 to February 2010 in the respondent’s home or at different palliative care units in Hordaland County in Norway.

Preliminary result: Time, context and care are related. The patients feeling of security for themselves and their relatives determine whether the time feels good or bad. It is evident that our relationship to time is expressed by body language. The body also communicates a rhythm, when health worker and the patients have different rhythm the care can become an unpleasant experience. Patients, relatives and health workers are in different aspects of time, normally we are prospective, when death are approaching the future become uncertain, which can entail that it is a challenge to meet in harmony in the present.

The aim of this study is to describe the experience of time as it presents itself at the place being situated when living with severe incurable disease and receiving palliative care. The empirical data consist of 26 open-ended interviews with 23 patients receiving palliative care at home, at a palliative day care, in a palliative bed unit in hospital or in a nursing home in Norway. A common meaning of a shifting space for living emerged from the analysis and was revealed through three different aspects: (i) Transition from a predictable to an unpredictable time: To live with severe incurable disease marks a transition to a changed life involving an ongoing weakened and altered body with bothersome symptoms making experience of time different and unpredictable. (ii) Transition between a safe and unsafe time: When time is unpredictable, feeling safe is revealed as essential to how time is experienced at the place being situated. (iii) To be in transition from a homely to a homeless existence: In a time of increased bodily weakness, unpredictable ailments and displacements, the sense of belonging to the place is revealed as significant to the experience of time. Not knowing where to be in a time of change is like an existential cry of distress where the foothold in existence is lost. The findings are discussed and interpreted as an embodied experience originating from the passage of time continually affecting life sometimes so fundamentally that it marks a transition to a changed space of life that is reflected in the experience of time. © 2013 Nordic College of Caring Science.

A phenomenological study describing the embodied experience of time when living with severe incurable disease This article presents findings from a phenomenological study exploring experience of time by patients living close to death. The empirical data consist of 26 open-ended interviews from 23 patients living with severe incurable disease receiving palliative care in Norway. Three aspects of experience of time were revealed as prominent: (i) Entering a world with no future; living close to death alters perception of and relationship to time. (ii) Listening to the rhythm of my body, not looking at the clock; embodied with severe illness, it is the body not the clock that structures and controls the activities of the day. (iii). Receiving time, taking time; being offered - not asked for - help is like receiving time that confirms humanity, in contrast to having to ask for help which is like taking others time and thereby revealing own helplessness. Experience of time close to death is discussed as an embodied experience of inner, contextual, relational dimensions in harmony and disharmony with the rhythm of nature, environment and others. Rhythms in harmony provide relief, while rhythms in disharmony confer weakness and limit time. © 2012 The Authors. Scandinavian Journal of Caring Sciences © 2012 Nordic College of Caring Science.

The aim of this study was to gain a deeper understanding of the experience of time when living with severe incurable disease. A phenomenological and philosophical approach of description and deciphering were used. In our modern health care system there is an on-going focus on utilizing and recording the use of time, but less focus on the patient’s experience of time, which highlights the need to explore the patients’ experiences, particularly when life is vulnerable and time is limited. The empirical data consisted of 26 open-ended interviews with 23 participants receiving palliative care at home, in hospital or in a nursing home in Norway. The theoretical frameworks used are mainly based upon K. Martinsens philosophy of care, K. E. Løgstrup phenomenological philosophy, in addition to C. Saunders’ hospice philosophy, L. Feigenberg’s thanatology and U. Qvarnström’s research exploring patient’s reactions to impending death. Experience of time is described as being a movement that moves the individual towards death in the field of opposites, and deciphered to be a universal, but a typical and unique experience emerging through three integrated levels: Sense of time; where time is described as a movement that is proceeding at varying speeds. Relate totime; where the awareness of limited life changes the understanding of time to be more existential. Being in time; where limited time seems to clarify the basic living conditions and phenomena of life. The existence of life when the prospect of death is present is characterized by emotional swings that move within polarizing dimensions which is reflected in the experience of time illustrated as the moves of the pendulum in a grandfather clock. The diversity of the experience of time is oscillating between going fast or slow, being busy or calm, being unpredictable but predictable, safe or unsafe and between being good or bad, depending on the embodied situation of the individual. © 2014, Springer Science+Business Media Dordrecht.

Background: Wellness is a holistic, multidimensional, and process-oriented property on a continuum. It has been used interchangeably with and is undifferentiated from concepts such as health and well-being without an in-depth clarification of its theoretical foundations and a reflection on its meaning. The concept of wellness is frequently used, but its definition remains unclear.

Aim: To conceptually and theoretically explore the concept of wellness to contribute to a deeper understanding in caring science.

Method: Rodgers' evolutionary concept analysis was applied to the theoretical investigation of data from publications of international origins. The focus was on antecedents, attributes, consequences, surrogate and related terms, and contextual references. A literature search was performed through a manual review of reference lists and an online search in CINAHL and PubMed via EBSCO, and in ProQuest. Abstracts were examined to identify relevant studies for further review. The inclusion criteria were peer-reviewed papers in English; papers published in scientific journals using the surrogate terms ‘wellness’, ‘health’, ‘health care’, and ‘health care and wellness’; and papers discussing and/or defining the concept of wellness. Twenty-six studies met the inclusion criteria.

Results: Based on the findings from this concept analysis, a definition of wellness was developed: ‘a holistic and multidimensional concept represented on a continuum of being well that goes beyond health’. Implications for nursing practice were correspondingly presented.

Conclusion: Wellness is defined as a holistic and comprehensive multidimensional concept represented on a continuum of being well, that goes beyond health. It calls attention by applying the salutogenic perspective to health promotion in caring science. It is strongly related to individual lifestyle and health behaviour and is frequently used interchangeably with health and well-being without an in-depth clarification of its theoretical foundation. © 2023 The Authors. Scandinavian Journal of Caring Sciences published by John Wiley & Sons Ltd on behalf of Nordic College of Caring Science.

The aim of this study was to describe the occurrence of vitality affects and basic affects and to shed light on their importance in terms of patients’ inner change through art therapy. In an earlier study, where 17 women were interviewed about inner change through art therapy, a secondary deductive content analysis of images and statements was performed exploring the presence of vitality affects and basic affects. Nine of the 17 interviews contained clear descriptions of vitality affects and basic affects in the intersubjective communication between the patient and the therapist; these affects were also mirrored in the patients’ painted images. Three cases are used to illustrate the result and how affects are related to inner change. These three cases differ from each other in that they describe vitality affects either; arising from the art therapist’s empathetic verbal or non-verbal response, from a particular experience in nature, or from the interpreted symbolic language of the image. The common denominator identified as uniting the three cases was the intersubjective communication with the therapist. This study indicates that image making in art therapy gives rise to vitality affects and basic affects that contribute to inner change. It also indicates the importance of having trust in both the method and the art therapist. © 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group

The aim of this study was to explore what art therapists consider to be patients’ inner change and how it may appear during art therapy. Thirty-eight trained art therapists with experience of using art therapy as a treatment were included in the study. They were asked to describe how they perceived their patients’ inner change and a situation during art therapy when they observed such a change. An inductive thematic analysis resulted in five themes; Therapeutic alliance, describing trust of the therapist and belief in the method, Creating, which concerns the work in the therapeutic process, while Affect consciousness, Self-awareness, and Ego-strength are part of the therapy outcome. The situations in which an inner change can be observed have been presented by means of quotations and discussed in relation to different theories and art therapy research. The participating art therapists formed a heterogeneous group, resulting in an unexpected consistency about what they considered to be an inner change in the patient. The study may be seen as a contribution to further discussion about the benefits of a more common language to describe patients’ inner change in art therapy. © 2017 The Authors. Published by Elsevier Ltd.

To date, consolation has not been clearly defined in nursing science. The purpose of this study was to identify the phenomenon of consolation from the perspective of practising nurses. Data from interviews with 21 nurses were analysed by means of the grounded theory approach. Consolation comprised supportive consolation, avoiding consolation, insufficient consolation and inaccessible consolation, which were integrated into the nurses’ professional approach and personal outlook. More basic research is required in order to illuminate the meaning of the phenomenon of consolation with focus on supportive consolation as well as the non-consolation phenomenon comprising the so-called avoiding, insufficient and inaccessible consolation. In order for nurses to be able to prescribe, carry out and evaluate consoling care which alleviates patient suffering, there is a need for further knowledge of what constitutes and does not constitute consolation.

To date, consolation has not been clearly defined in nursing science. The purpose of this study was to identify the phenomenon of consolation from the perspective of practising nurses. Data from interviews with 21 nurses were analysed by means of the grounded theory approach. Consolation comprised supportive consolation, avoiding consolation, insufficient consolation and inaccessible consolation, which were integrated into the nurses’professional approach and personal outlook. More basic research is required in order to illuminate the meaning of the phenomenon of consolation with focus on supportive consolation as well as the non-consolation phenomenon comprising the so-called avoiding, insufficient and inaccessible consolation. In order for nurses to be able to prescribe, carry out and evaluate consoling care which alleviates patient suffering, there is a need for further knowledge of what constitutes and does not constitute consolation.

Aim: The aim of this study was to highlight community nurses' experiences of ethical dilemmas in palliative care.

Background: There are many studies on palliative care but research on how community nurses experience ethical dilemmas in palliative home care is lacking. The ethical dilemmas to which these nurses are exposed seriously challenge their ethical competence.

Method: Seven community nurses described their experiences of ethical dilemmas in palliative home care. The data was analysed by means of qualitative content analysis.

Findings: The core themes that emerged were: powerlessness, frustration, and concern in relation to ethical dilemmas in palliative care. The nurses were motivated and felt responsibility for their patients' end of life, and their relatives, and took their duties seriously. They wanted to satisfy all parties; the patient, the relatives and other palliative care professionals.

Conclusion: The study confirms the need for knowledge about how community nurses experience dilemmas in ethical decision-making. They have the freedom to act and the willingness to make decisions, but they lack competence and knowledge about how their colleagues' experience and deal with such issues.

This study illuminates how existential needs and spiritual needs are connected with health care ethics and individuals’ mental health and well-being. The term existential needs is defined as the necessity of experiencing life as meaningful, whereas the term spiritual needs is defined as the need of deliverance from despair, guilt and/or sin, and of pastoral care. It discusses whether or not patients’ needs are holistically addressed in Western health care systems that neglect patients’ existential and spiritual needs, because of their biomedical view of Man which recognizes only patients’ physical needs. It excludes a holistic health care which considers all needs, expressed by patients in treatment of mental illness. Addressing all needs is important for patients’ improvement and recovery. For some patients, this is the only way to regain their mental health and well-being.

Purpose: Describe community nurses’ experiences regarding the meaning and promotion of healthy aging in northeastern Thailand. 

Method: Data were collected through five focus group interviews with 36 community nurses in northeastern Thailand. Latent content analysis was conducted to analyze the data. 

Findings: Healthy aging was characterized by the interconnection of older persons, older persons’ family members and the community. Healthy aging was associated with two themes: “being strong” and “being a supporter and feeling supported”. The nurses’ experiences in promoting healthy aging were described using the themes “providing health assessment”, “sharing knowledge” and “having limited resources”. 

Conclusions: The findings of this study provide a deeper understanding of the meaning of healthy aging from a holistic viewpoint. Community nurses must pay attention to older persons and their surroundings when planning how to promote healthy aging. Person-centredness should be applied in practice to promote healthy aging. The current findings contribute useful information that should help policy makers develop healthy-aging strategies in Thailand. © The Author(s) 2017

The aim of this study was to describe factors associated with perceived health and healthy aging among older people in northeastern Thailand. Thailand’s aging population is growing and facing an increasing old-age dependency ratio. Northeastern Thailand, known as Isan, is a region in which the number of older residents is projected to grow rapidly. Older people in this region are likely to confront great threats to their health and well-being. These issues require appropriate attention and actions to promote healthyaging. However, healthy aging in this region has not been studied. A cross-sectional study was conducted on a sample of 453 older people, aged 60 years or older. Participants completed the Healthy Aging Instrument (HAI) and provided relevant demographic characteristics. Mann-Whitney U tests, Kruskal-Wallis tests and multiple regression models were used to analyze the data. Through comparative analyses, significant differences in HAI scores were observed for the following factors: marital status, residential area, disability, income level, and perceived meaningfulness in life. In the multiple regression models, residential area, disability, and marital status explained 24.30 % of the variance in HAI scores. Health promotion strategies and future targeted intervention programs should consider the importance of these factors. © 2016 The Author(s)

Healthy ageing is a concept that concerns older persons’ quality of life and is a key factor in promoting wellbeing. 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 life world 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 older 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 aging is valuable for healthcare providers. They can apply these findings regarding healthy ageing in their fieldwork when caring for older people. © 2016 P. Manasatchakun et al.

In Thailand, family nurses are expected to provide support for older persons and their family members to promote healthy aging. Family bonds are strong, and relatives are expected to take care of their older family members. However, there is limited research on how older persons’ family members perceive healthy aging. This study aimed to describe the conceptions of healthy aging held by the children and grandchildren of older persons in northeast Thailand. In a phenomenographic study, 14 interviews were performed to qualitatively analyze different conceptions of healthy aging. Four descriptive categories emerged: being independent, not being afflicted by diseases or illnesses, being a giver and a receiver, and being wise. The conceptions of healthy aging entail both autonomy and interdependence. The relative’s perspective needs to be considered when policies relating to healthy aging are implemented in the community and when family nurses provide support to families to promote healthy aging. © 2018 Pornpun Manasatchakun et al.

Purpose: Health beliefs are usually regarded as subjective understandings of one’s health. They can, however, be re-interpreted by drawing on the understanding that the structural features of the health discourse resemble the characteristics of a religion and on the spiritual dimension of health with its possibly salutogenic influence. The applicability of the notion of“health religiosity” and its consequences for individual health promotion are explored.

Method: Data consist of already existent semi-structured interviews. These have been reana- lyzed in a deductive-hermeneutical way by using a five-dimensional concept of religiosity as deductive template.

Results: The concept of religiosity proved to be productive and revealed that all health dimensions in the case are infused with spiritually ennobled ideas.

Conclusion: We conclude that, irrespective of their factual accuracy, the salutogenic potential of ennobled ideas may best be utilized by understanding them hermeneutically. An explora- tion of a narrative hermeneutic approach to individual health promotion is suggested as the merging of meaning horizons in a hermeneutic dialogue is expected to increase awareness of spiritualized aspects of health beliefs. This may mitigate healthism and health disparities. Moreover, three challenges for individual health promotion are anticipated: realizing the situation, recognizing its complexity and resisting a simplistic practical approach. © 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

BACKGROUND: There is a need for a short and easily administered scale, in the Swedish language, for assessing partner relationships in the health care of persons with cardiac disease. PURPOSE: To establish the reliability and validity of the Swedish version of the Relationship Assessment Scale (RAS). DESIGN: The present pilot study has a methodological design. FINDINGS: Content validity has been tested for relevance, clarity and readability. The scale was tested for construct validity with explorative factor analysis. The reliability was tested by internal consistency and test-retest analysis. The result showed a two-factor solution, which does not correspond to the original proposed one-factor solution. The factor analyses revealed two quite distinct factors of RAS, labelled "Relationship built on expectations and satisfaction of needs" and "Relationship built on love and devotion". CONCLUSIONS: The scale has satisfactory psychometric properties in terms of content validity, construct validity, homogeneity and stability in a population of persons with cardiac disease. Wider evaluations of the RAS for other populations and settings are recommended.

Syftet med denna artikel är att undersöka tröstens innebörd, med fokus på vårdande och icke-vårdande tröst såsom den framträder i Jobs bok i Gamla testamentet. Analysen visar att Job upplever den tröst som förmedlas till honom som frånvaro, frånvarande tröst och närvaro, närvarande tröst. Några dimensioner av den frånvarande trösten är att den förminskar lidandet och är en tröst som stannar vid ytan. Den närvarande trösten framträder i dimensioner som karakteriseras av en öppnande tröst och en motsägelsefull tröst. I artikeln urskiljes en vårdande och icke-vårdande tröst, och argumenteras för att även vårdarna själva upplever tröst av att förmedla en tröst som vårdar den lidande.

Vad är tröst och Hur trösta? Svaren på frågorna tycks givna. Forskning visar emellertid att tröst inte alltid är vad vi tror att den är, önskar att den skulle vara och förmedlas på sätt som vi minst anar. Frågan är vilken betydelse tröst har för människor idag på 2000-talet och hur viktig tröst och tröstande är för vårdvetenskap.

Syftet med avhandlingen är att, ur ett vårdvetenskapligt, och ett i detta inkluderat vårdteologiskt perspektiv, belysa innebörden av fenomenet tröst och hur tröst förhåller sig till lidande och vård. Det görs i två empiriska intervjustudier med vårdare och äldre vårdtagare samt en tredje delstudie som analyserar tröst såsom den framstår i Jobs bok i Gamla testamentet. Dessa delstudier behandlar vårdares upplevelse av tröst och att trösta, äldre vårdtagares upplevelse av tröst samt Jobs upplevelse av tröst.

Metodologiskt har forskningen sin utgångspunkt i fenomenologi och hermeneutik. En fenomenologisk-hermeneutisk metod, inspirerad av Paul Ricoeur, har använts för textanalyserna. I avhandlingen behandlas också det som är signifikant för poetisk och religiös text. De metaforer som förekommer i de empiriska delstudierna med vårdare och äldre analyseras för att ta tillvara det överskott av mening som metaforer, enligt Ricoeur, kan uttrycka.

Resultatet visar fem övergripande innebörder: Den motsägelsefulla trösten, Den sammanbindande trösten, Den stumma trösten, Den okontrollerade trösten och Den vilsamma trösten. En vårdande tröst är motsägelsefull såtillvida att den innebär dels att den lidande överlämnar sitt lidande till någon annan, dels att lidandet kan ges tillbaka för att lidas. Tröst kan således vara att lida. En sammanbindande tröst är närvarande, d.v.s. är hos den lidande och utgår från dennes lidande. Denna tröst kännetecknas av djup gemenskap, en upplevelse av att vara förstådd på ett djupare sätt. Resultatet visar också en tröst som är stum. Denna tröst svarar inte an på den lidandes upplevelse av sitt lidande, är oformlig och saknar följsamhet för lidandet. Ett exempel på en stum och icke-vårdande tröst är vännernas tröst i Jobs bok. Denna tröst förmår inte trösta därför att den inte är där Job är, d.v.s. i hans upplevelse av sitt lidande. Vidare framstår en vårdande tröst som okontrollerad därför att den dels är spontan, dels bistår den lidande att släppa kontrollen över lidandet. Att släppa kontrollen innebär bl.a. att den lidande ger upp försöken att förstå lidandet för att istället låta det oförståeliga vara oförståeligt. Genom att ge upp det som på olika sätt binder lidandet infinner sig en tröstande och hälsobringande vila i eller från lidandekampen.

Resultatet som helhet tolkas ur ett vårdvetenskapligt perspektiv som vårdgemenskap, tro, hälsa och offer. Tröst som hälsa förstås utifrån en teoretisk modell, inspirerad av Katie Erikssons ontologiska hälsomodell. Filosofiskt-etiskt belyses forskningen utifrån företrädesvis Emmanuel Levinas. Resultatet diskuteras i förhållande till tidigare forskning och i förhållande till vårdvetenskap, samhälle och vård.

The purpose of this theoretical article is to discuss the existential and universal feature of suffering-as illustrated by Job's suffering in the Book of Job in the Bible and by the survivors of the 2004 Asian tsunami catastrophe-and to highlight its significance for health care. Further, the study is aiming at contributing to health professionals' understanding of patients' suffering. The sources are narratives, comprising Job's book, TV interviews 1 year after the tsunami catastrophe and the survivors' autobiographies. The methodological approach is a philosophical analysis. The existential, universal, ontological and epistemological aspects of suffering are carefully scrutinized to unveil the universal and existential versus culture-specific features of suffering. Based on the results, the authors' recommendations are (1) a holistic concept of the patient and health care has to seriously consider suffering in all its complexity because when a person is in pain, it is not his/her body but the whole person as a unity of body, psyche and spirit that suffers and (2) suffering should be seen as the most central concept of health care, which should provide treatment for physical pain and all dimensions of suffering: physical, social, mental and spiritual aspects. © 2014 Springer Science+Business Media New York.

The aim of the study was to explore the meaning of consolation as experienced by Job in the Book of Job and as presented in literature and how consolation relates to suffering and care. The study’s theoretical design applied Ricoeur’s view on phenomenology and hermeneutics. The resulting themes were as follows: consolation that is present, that originates in confrontation, that keeps suffering at a distance, that does not alleviate suffering, that originates in experience from giving comfort, and that facilitates a change of perspective. The authentic and caring consolation accepts the sufferer’s incomprehensible “otherness” but however provides no answers about how to console. © 2011 Springer Science+Business Media, LLC.

The tsunami catastrophe, 26th December 2004, is one of a number of catastrophes that has stricken mankind. Climate reports forecast that natural disasters will increase in number in the future. Research on human suffering after a major catastrophe, using a caring science perspective, is scarce. The aim of the study was to explore the meaning of suffering and relieved suffering of survivors of the tsunami catastrophe, 26th December 2004. An explorative study design, inspired by the French philosopher Paul Ricoeur’s hermeneutic-phenomenology, was used. Interviews made by the Swedish Television (SVT) in connection with the 1 year anniversary were carried out on site in the disaster area and in Sweden. The text analysis revealed four main themes: ‘An incomprehensible event’, ‘A heavy burden’, ‘Help that helps’, and to ‘Being changed in a changed life situation’. The findings were mainly interpreted in light of Paul Ricoeur’s thinking on suffering, quilt, forgiveness, time and narrative. The first year after the loss of loved ones in the tsunami catastrophe, 2004, was like starting an inner as well as an outer journey. This journey was experienced as living with the heavy burden of an incomprehensible event. Help that helped was mediated by consolers who endured the suffering of the other. An ‘enduring courage’ is a key moral virtue to encounter the alienation of the sufferer and how it in turn alienates from the sufferer. It is also important to recognize that the complexity of the world of those who have lost loved ones in major catastrophes includes possibilities for reconciliation with the loss. The reconciliation creates hope that opens up for being changed in a changed life situation.© 2010 The Authors. Scandinavian Journal of Caring Sciences © 2010 Nordic College of Caring Science.

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.

Aims and objective. The aim of this study was to illuminate nurses’ experiences of consolation and how these experiences relate to suffering and care.

Background. Consolation is commonly associated with the relief of suffering. The question of consolation in terms of its definition and relevance for care has, however, been a matter of discussion among nurse researchers. The question raised concerns about the nature of consolation, its place and its role in relation to care and the caring sciences.

Design. An explorative qualitative interview study with 12 participants, six registered and six enrolled nurses, was carried out in a home-care context.

Methods. A phenomenological-hermeneutic method inspired by the French philosopher Paul Ricoeur was used for the text analysis.

Results. Two main aspects of consolation appeared: ‘the present consolation’, which is flexible, sustaining and opening and ‘the absent consolation’, which conceals the suffering and is incapable of consoling. The result was interpreted from a philosophical-ethical perspective, based on the works of Levinas and Lögstrup.

Conclusions. Consolation appears as a complex phenomenon, both in terms of its existence and its absence consolation, constituting a caring and non-caring consolation. A caring consolation entails meeting the other as different and being present in a way that gives the other space to be the one he or she really is. It requires acceptance, accepting the sufferer and his/her way of suffering as unique.

Relevance to clinical practice. The clinical nurse is involved in complex care situations, which entails both reflecting upon and using intuition when consoling. A caring consolation is a contradictory phenomenon that requires a nurse to be capable of both reflecting upon and acting intuitively on the unique suffering of the other. © 2008 Blackwell Publishing Ltd.

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. © 2010 Å. Roxberg et al.

Purpose: This discussion paper aims to contribute to a greater understanding of the state of the art of research engaged with conceptual matters of space and place for health and care.Method: The authors, who represent a variety of academic disciplines, discuss and demon- strate the conceptual recognition of space and place in research in health and caring sciences building upon own work and experience.

Results: To explore the concepts of space and place for health and care is a research pursuit of utmost importance, and should be made through transdisciplinary research collaborations, whereby spatial theories from various disciplines could be communicated to cultivate truly novel and well-informed research. Furthermore, engaging with relational and topological perceptions of space and place poses methodological challenges to overcome in future research on health and care.

Conclusions: We argue that there is a need for accelerating spatially informed research on health and care that is informed by current theories and perspectives on space and place, and transdisciplinary research collaborations are a means to achieving this. © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

The aim was to explore magnetic resonance imaging (MRI) experiences of patients with spinal metastasis after adjustments to the examination procedures have been made in accordance with the findings from a previous study. MRI is an important medical technology, which is considered to be the first choice of examination method when diagnosing and evaluating spinal metastatic tumors. It is a challenge to care for patients who experience anxiety and pain during an MRI. However, several aspects of the examination can be adjusted to improve the care for these patients. Findings from previous research were used to develop a care intervention, the effects of which are explored in this study. Qualitative deductive-inductive content analysis was used in this study. Eleven patients with spinal metastasis were interviewed about their experiences of going through an MRI scan based on an intervention designed in accordance with the findings from previous research. The findings showed that adjustments to the examination often were perceived as beneficial. However, patients needed to be involved in the decisions that influenced their own care. Time was an important component that affected the need for being prepared as well as the degree of personalization of the examination. This study shows that patients need to be seen as unique individuals, and they need to be able to influence the care that is given to them. The personalization of and adjustments to the examination routines need to be carried out in agreement with the patient. © 2018 Association for Radiologic & Imaging Nursing

Magnetic resonance imaging (MRI) is without question the best tool used for diagnosing and evaluating spinal metastasis. An MRI examination is known to be of great value for the treatment planning and survival of these patients. Radiographers have an important role in how the quality of care is experienced by the patients during an MRI examination. The purpose of the study was to describe the radiographers’ perceptions of caring for patients with spinal metastasis during an examination with MRI.

Methods: Phenomenography was used to analyze the data in this study. Ten radiographers, one male and nine females were interviewed about their perception of caring for patients with spinal metastasis during an MRI examination.

Results: The findings showed that the radiographers’ caring perspective influenced their approach towards what they consider to be essential in the care of patients with spinal metastasis. This can impact the extent of the adjustment to the care needs of the patients. Furthermore, the findings showed that there was a strong connection between the radiographers’ care approach and preparedness to personalize the care.

Conclusion: This study shows that it is important to be flexible when providing care for the patients. A person-centered care is achieved when the caring perspective is based on the patient’s view and adjustments are made in agreement with the patient. © 2017 The College of Radiographers.

The aim of the study was to explore the experience of a magnetic resonance imaging (MRI) examination by patients with neoplasm metastasis in the spine. MRI is the most accurate method to diagnose and evaluate suspected metastatic disease in the spine. Patients may experience anxiety because of the fear of pain, fear of the unknown, and the apprehension about what the test might reveal. The study had a qualitative design, and the collected data were analyzed by means of latent content analysis. Twelve semistructured in-depth interviews were carried out starting with the question “Can you tell me about your experience of the MRI examination?” Four themes were identified: “motivation,” “worry and anxiety,” “insecurity,” and “security.” The patients were highly motivated to be examined by MRI, although most of them did experience some degree of worry or anxiety. The level of worry or anxiety was generated by the perception that an MRI examination was unpleasant, uncomfortable, or by the fear of what the result would show. All participants experienced some degree of insecurity, but in different ways, the insecurity of the patient could be reduced and the patients could experience a greater degree of security. The feelings of insecurity or security could be influenced by the radiographer, patients themselves, and MRI equipment. This study shows that most patients usually experience worry and anxiety. If the patients are motivated, they can manage to go through the examination in spite of the previously mentioned adverse feelings. Patients' feelings tend to fluctuate between a sense of insecurity and one of security. © 2014 Association for Radiologic & Imaging Nursing.

The purpose of this study was to evaluate the psychometric properties of a Swedish version of The Krantz Health Opinion Survey (KHOS). A convenience sample of 79 persons (47 men and 32 women) was recruited from The Heart and Lung Patients’ National Association at ten local meeting places in different areas in Sweden. The questionnaire was examined for face and content validity, internal consistency and test-retest reliability. The findings showed that the Swedish version of KHOS is acceptable in terms of face and content validity, internal consistency and test-retest reliability over time among 79 individuals >65 years of age and with a cardiac disease. In conclusion, wider evaluations of the psychometric use of KHOS for other populations and settings are recommended.

The patients’ sexual life after a myocardial infarction is important for his/her quality of life. In spite of this, many patients are in doubt regarding their sex life after a myocardial infarction (MI) and the sexual information received, and counselling from health care providers has been seen to be insufficient. The purpose of this study was to evaluate the psychometric properties of ‘The 25-item Sex after MI Knowledge Test’ in a Swedish context. A convenience sample was recruited. The scale was translated into Swedish and completed by 79 former patients from The Heart and Lung Patients’ National Association on two occasions, with an interval of 2 weeks. The scale was tested for face and content validity, internal consistency and test–retest reliability. The result in this study indicates that the instrument has good face and content validity and displayed a moderate internal consistency (alpha 0.61). The instrument showed some level of instability in test–retest reliability with 60% of the items presenting moderate or strong agreement between the test and retest. Further studies that use this instrument in larger and more diverse samples are thus needed.

The aim of the study was to gain a greater understanding of the experiences of guilt of the next-of-kin in end-of-life care. Seventeen next-of-kin who had lost a loved one were interviewed with a focus on possible experiences of guilt. A Gadamerian-based hermeneutic approach to interpret these experiences was used. The interpretation showed that next-of-kin’s experiences of guilt emanated from a situation where the next-of-kin had a moral view on what was the right thing to do, it could also originate from a wish to do the best possible for the dying person out of love for this person. The situation could also involve both these aspects.  The way in which the situation was handled, could, if the next-of-kin felt that s/he did not fulfill her/his commitments, omitted or neglected the dying person or was the cause of something, lead to experiences of guilt. The situation of being next-of-kin in end-of-life care is complex and demanding, something that health professionals are and should be aware of. Acknowledgement of experiences of guilt can help the next-of-kin in their adaptation to the end-of-life situation as a whole and maybe also give useful tools to support next-of-kin through bereavement. © 2013 The Hospice and Palliative Nurses Association

The “room” in end-of-life is a phenomenon that needs deeper understanding as it is a dimension that shows how health and suffering are shaped. Research on the concept of room was chosen as theoretical foundation in this study in order to reach a profound understanding of the next-of-kin’s “room” in end-of-life care. Lassenius’s hermeneutic interpretation in metaphorical language was used as an deductive-inductive approach to the empirical data. The data material comprised 33 interviews with next-of-kin about their experiences of end-of-life care when being close to a relative dying from a cancer disease. The analysis of the data formed four cases: the Standby, the Asylum, the Wall, and the Place. These cases lend their voices to the experiences of the next-of-kin in the study. The findings of this study explain and may well assist nurses to understand the experiences of being next-of-kin in end-of-life care as forming a room of rest from the suffering, a room of controlling the suffering, a room of hiding from the suffering, and a room of belonging.

© 2015 Carina Werkander Harstäde and Åsa Roxberg

Background

The theoretical viewpoint of the study was based on the fundamental motive in caring science; the suffering person and his/her health and life situation, which according to the philosophy of palliative care also includes the next-of-kin. The latter often wish to participate in the care of their loved ones and it is thus important for them to be able to make decisions that can generate a meaningful participation. Unfulfilled obligations or wrong decisions, concerning their dying relative, can result in experiences of guilt and shame in relation to the care of the loved one. A semantic concept analysis can provide a deeper understanding of these concepts and create a deeper insight into what the concepts mean for the individual.

Aim

The aim of the study was to elucidate the meaning of and the distinction between the concepts of guilt and shame.

Methods

Semantic concept analysis based on Koort and Eriksson.

Findings

The findings show that guilt and shame are two separate concepts. Guilt contains meaning dimensions of being the cause of and sin. Shame contains meaning dimensions of something that gives rise to shame and ability to experience shame. The synonyms for each concept do not overlap each other

Conclusion

The semantic analysis creates an understanding of the concepts ontologically and provides a basis for theoretical, contextual and clinical understanding and development. © 2012 Nordic College of Caring Science.

The aim of this study was to gain a greater understanding of the experiences of shame of next of kin in end-of-life care. Seventeen next of kin who had lost a family member were interviewed. A method inspired by Gadamer's hermeneutic approach was used to interpret possible experiences of shame and to discuss these interpretations. The result showed that next of kin's experiences of shame are linked to their perception of the remaining time and are guided by views on morality and what is right and wrong. Shame can occur when the next of kin are involved and actually cause harm to the family member as well as in situations that are beyond their control. Shame can also involve actions that have nothing to do with what they have actually done but is instead a shame that is placed on them by others, for example, health professionals or relatives. Shame is interpreted as experiences of ignominy, humiliation, and disgrace. Second-order shame is also found. It is important that health professionals are aware of these experiences of unhealthy shame when they meet and support next of kin in end-of-life care. © 2014 by The Hospice and Palliative Nurses Association.

Denna vårdvetenskapliga jubileumsskrift tar läsaren med på en resa genom den utveckling som skett av ämnet vid forskarutbildning i vårdvetenskap vid Växjö universitet. Många bäckar små… ett talesätt som kan illustrera det gemensamma arbete och den samlade kunskap som ligger bakom denna skrift. I skriften får vi stifta bekantskap med vårdvetenskapen i varierande kontexter alltifrån rättpsykiatri till akut- och hemsjukvård. Sammanställningen av den vårdvetenskapliga forskning som under denna femårsperiod har gjorts på IVOSA visar att vårdvetenskapen är en autonom vetenskap med en tydlig substans eller kärna. I kärnan finns patienten, och ämnet tar sin utgångspunkt i människors existens. Med fokus på människan som är i behov av vård framträder lidande, hälsa och välbefinnande som väsentliga begrepp. I bokens delar fördjupas och kontextualiseras vårdvetenskapen i skiftande vårdande liksom lärande miljöer. En vårdvetenskap med grund i ett patientperspektiv behövs såväl akademiskt som i vården för att anta både dagens och morgondagens utmaningar.