Abstract: OBJECTIVE: to identify and describe the meaning of the routine ultrasound scan to pregnant women. DESIGN: a qualitative descriptive study using a grounded theory approach, with individual interviews to collect data. SETTING: three antenatal clinics in a Swedish county of approximately 400,000 inhabitants. PARTICIPANTS: voluntary samples of 10 pregnant Swedish women, 26-38 years of age, were interviewed prior to their first routine ultrasound. FINDINGS: 'making it possible' was the core category that explained and illustrated the meaning of the scan. The core category showed that the women considered the examination to be filled with possibilities to reach different goals during pregnancy. It also explained the categories: ultrasound as an event; ultrasound as a situation; ultrasound as a test; and the effects of ultrasound; as well as how they related to each other. The findings are considered the beginning of a theory concerning the meaning of the first ultrasound to pregnant women. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: pregnant women can see their first ultrasound as a tool that enables them to reach different goals during their pregnancy. Many of the goals concern meeting and connecting with the baby, suggesting that pregnant women consider the examination an important step towards parenthood. An ultrasound examination offered for medical reasons, which has other meanings than the intended for pregnant women, is important knowledge. It can be useful when giving information about the scan, addressing the woman during the examination, and for understanding and handling possible reactions.
Abstract: The aim of the study was to describe how foreign-born and Swedish born families living in Sweden perceive psychosis care. Eleven foreign-born and 15 Swedish-born family members were interviewed and the data were analyzed using a phenomenographic approach. The findings showed three main descriptive categories: taking responsibility, access to care, and attitudes to psychosis. The degree of responsibility in the family decreased if there was easy access to care and support from health-care staff. Knowledge of psychosis was considered to be important in order to counteract prejudiced attitudes in the family and the community. Foreign-born families did not want to be treated differently from Swedes and stressed the importance of finding ways to communicate despite communication barriers. Foreign-born families also were affected by their experiences of psychiatric care and different beliefs about psychosis in their home country. The results indicate how important it is that health-care staff members treat families on equal terms. It is necessary to take the time to identify how to communicate in a good manner and to identify families' previous experiences of and beliefs about psychosis care in order to help families face prejudice in society and to see beyond the psychosis.
Abstract: BACKGROUND: Myocardial infarction has pronounced effects on an individual that demand changes in lifestyle. Health is influenced by whether the individual experiences the world as comprehensible, meaningful, and manageable, that is, has a sense of coherence (SOC). High SOC scores indicate that the individual probably manages the situation by understanding the context and connections: action and effect. OBJECTIVE: The study objective was to identify the SOC, assess the quality of life (Short Form-12 Health Survey Questionnaire), assess the symptoms using the Seattle Angina Questionnaire, and create health curves from a baseline for patients with a first myocardial infarction. METHODS: A longitudinal and predictive study of 100 participants in the heart care unit of a county hospital in southern Sweden was performed. RESULTS: Women score lower on SOC than men. Persons with high SOC scores have fewer angina attacks, are more physically active, drink more alcohol, are more satisfied with their treatments, and have better disease perception. CONCLUSION: By following SOC scores, a trend emerges that suggests it may be a useful tool for identifying those who will need extra support.
Abstract: Palliative care seeks to enhance quality of life in the face of death by addressing the physical, psychological, social, and spiritual needs of patients with advanced disease. The purpose of this paper is to explore whether palliative patients' needs, nursing actions, and evaluation can be identified in the nursing documentation. Data consisted of reviews of patients' case records in a palliative care unit. Data were analyzed using content analysis and counting frequency of keywords used from the Well-being Integrity Prevention and Safety (VIPS) model, followed by an inductive analysis of the case record documentation aiming to identify palliative care components. The result shows that the documentation revealed physical care, especially pain, more frequently than other needs. Nursing documentation focuses on identification more than on nursing actions and evaluation.
Abstract: Lung cancer is a disease with many biomedical and psychological symptoms. The diagnosis and treatment of lung cancer induces adverse effects. Having an inoperable lung cancer there are few possibilities of being cured. Management of patients with inoperable disease is directed at relieving local or systemic symptoms. The purpose of this study is to describe how it affects the patients' life situation and quality of life. Data was collected by qualitative interviews where the patient's lived experiences were articulated. Twenty-three Swedish patients diagnosed and starting palliative treatment for inoperable lung cancer were interviewed. The interviews were audio-taped and transcribed verbatim. Data were interpreted trough interpretive phenomenology. Six themes were identified that were important for the informants' experience of their life situation and quality of life. The themes were: Experience of uncertainty; including time of waiting and thoughts, experience of hope; about a prolonged life, network as support; being treated as the person they are thoughts of death; is there time to conclude their lives?, feelings of shame and guilt; they have caused the disease by themselves and next of kin reactions; sadness, guilt, worries and anger. These six themes gave a structure presenting the essence: Living as usual. Maintaining independency and integrity were important, as well as maintaining status, being treated as the person they always had been and that they experience that they had a meaning to fulfill in life. They were living as usual. The findings of this study point out the importance of improving the care of people afflicted with lung cancer, as well as promoting support for the next of kin, since they are significantly important for these patients' experiences of quality of life. This knowledge and understanding will be useful for development of interventions and guidelines for treatment.
Abstract: The purposes of this study were to identify and describe the impact that social support and a social network has for adult people recently diagnosed with lung cancer in Sweden. Ten lung cancer patients participated. The data were collected using qualitative interviews based on an interview guide and were analyzed using constant comparative analysis. This led to a core category, "receiving confirmation as a person", which was grounded via four categories: "good relationships within a social network", "conversation enables support", "confidence in the situation", and "to manage by oneself". These categories were all related to each other. How these categories might have a positive influence on a person and give them the strength to move on were also clarified. The social network identified comprised of a few people who were close to the patient. The knowledge gained from this study can be used when developing care guidelines at different levels for use by health-care professionals.
Abstract: The underlying causes of metabolic syndrome (MS) are uncertain. Knowledge from those who have experience of this syndrome should provide new insight. The aim was to explore the meaning and consequences of MS. Thirteen Swedish adults with MS, aged between 33 and 82 years, were interviewed. The interviews were analyzed using constant comparative analysis, which is the basis of grounded theory. The core category for the meaning and consequences of having the risk factors of MS consisted of the recurrence of behavior. The participants attempted to balance their insight into the causes and consequences by referring to their normal life, lifestyle, and fatalistic approach to life. Attention needs to be paid to the attitudes of the individuals with MS, as well as the known risk factors and their consequences, in order to facilitate a long-term lifestyle change in these individuals.
Abstract: PURPOSE: Many young women suffer from pain and discomfort during sexual intercourse, and an increasing number of them seek help for their problems. It seems that some young women continue to have sexual intercourse despite pain. However, their motives are unclear. METHODS: A total of 16 women, aged 14 to 20 years, with variable degrees of coital pain were selected at a youth center in a city in southeastern Sweden, to explore why they continued to have sexual intercourse despite pain. The women participated in audiotaped qualitative individual interviews, which were analyzed using the constant comparative method from grounded theory. RESULTS: During the analysis we identified the core category striving to be affirmed in their image of an ideal woman and the categories resignation, sacrifice, and feeling guilt. The perceived ideal women had several distinct characteristics, such as willingness to have sexual intercourse, being perceptive of their partner's sexual needs, and being able to satisfy their partners. Having sexual intercourse per se was considered to be an affirmation of being a normal woman, irrespective of pain or discomfort. CONCLUSIONS: These young women's focus on a constructed ideal explains why they continue to have sexual intercourse despite pain. Greater awareness of these beliefs among gynecologists, sexologists, and other healthcare professionals involved in the management of young women with coital pain would be beneficial.
Abstract: OBJECTIVE: To gain a deeper understanding of how female medical students perceive and experience performing their first pelvic examination (PE). METHODS: A qualitative study. In-depth interviews after the students' involvement in a learning session about the PE, with professional patients (PPs) as instructors and a gynaecologist as supervisor. The interviews were analysed according to the constant comparative method to acquire a deeper understanding of the students' experiences and the ongoing social processes. RESULTS: "Transcending unspoken boundaries and taboos, a prerequisite for learning" was the essence of the entire material and was identified from two categories: "A didactic design facilitates the transition to examiner" and "Interactive support enables creative learning of interpersonal and palpation skills". CONCLUSION: Through interactive guidance from the PPs, the students overcame affective obstacles and achieved the aim of becoming an examiner. The favourable learning experience heightened their awareness of their own bodies and promoted a deeper interest in PEs, both as examiners and as patients. PRACTICE IMPLICATIONS: Engaging voluntary, healthy and knowledgeable women as instructors in the PE situation creates a safe learning environment and promotes interaction with students. Immediate feedback teaches students to integrate communicative and behavioural skills in a professional manner and to palpate the uterus.
Abstract: OBJECTIVE: In a study performed with The NorVold Abuse Questionnaire (NorAQ) among Nordic gynecological patients, the prevalence of lifetime abuse in health care (AHC) was 13 - 28%. In the present study we chose a qualitative approach. Our aim was to develop a more in-depth understanding of AHC; as experienced by female Swedish patients. STUDY DESIGN: Qualitative interviews with 10 Swedish gynecological patients who had experienced AHC. The interviews were analyzed through Grounded Theory. RESULTS: Saturation was reached after six interviews. In the analyses four categories emerged which explain what AHC meant to the participating women: felt powerless, felt ignored, experienced carelessness, and experienced non-empathy. To be nullified is the core category that theoretically binds the four categories together. The women's narratives described intensive current suffering even though the abusive event had taken place several years ago. CONCLUSIONS: The fact that AHC exists is a critical dilemma for an institution that has the society's commission to cure and/or to alleviate pain and suffering. In their narratives, women described the experience of 'being nullified', a core category that embodies AHC.
Abstract: There has been a great deal of qualitative research conducted that has examined the impact of breast cancer on the Self, however, there has been little effort to analyze these findings from a meta-perspective. This study sought to fill this gap by conducting a meta-synthesis of the qualitative research on breast cancer and its treatments affecting the Self. Meta-method and meta-synthesis techniques were used to integrate findings across 30 qualitative research reports conducted between 1990 and 2003 with a total of 795 women, from several different countries.The fusions identified from this meta-synthesis revealed 4 aspects of the Self affected by the diagnosis of breast cancer and its treatment: awareness of their own mortality, living with an uncertain certainty, attachment validation, and redefinition of Self. These findings were validated through use of a comparison study. The women adapt to being a breast cancer patient; redefining their lives and their self. This study highlights the existential process that women of many cultures move through as they incorporate the meaning of breast cancer into their lives. Nurses who are aware of these processes are better able to link women with resources to help them in their adaptation to living with breast cancer.
Abstract: OBJECTIVES: Cancer is a complicated issue both medically and psychosocially, and the process of the disease affects the whole human being. Fatigue is the commonest symptom associated with cancer and its treatment. Prostate cancer is the third commonest male cancer worldwide and the leading cause of male cancer death. The aims of this study were: (i) to identify whether fatigue is found in men with newly diagnosed localized prostate cancer (predominantly early-stage, very low tumour burden asymptomatic patients); and (ii) to gain a perception of whether fatigue has an influence on these men and to try to find out what the cause of this fatigue was. MATERIAL AND METHODS: Sixteen men who had been newly diagnosed with localized prostate cancer were interviewed to determine whether fatigue is experienced by such men and whether it has an effect on them. Verbal transcripts were analyzed using hermeneutical interpretation. RESULTS: Five equivalent fusions were identified according to the time when the participants received their diagnosis of early-stage prostate cancer. These fusions occurred successively, in three steps. The first step was Enclosing Intrapersonal Emotions and Enclosing Interpersonal Attachments, when the men were living in a kind of vacuum. Moving onto step two, another two fusions were triggered and contributed to a positive attitude: Reopening Intrapersonal Emotions and Reopening Interpersonal Attachments. Finally, at step three, a unifying fusion was identified: Living with a New Perspective. This study provides insights and new knowledge indicating that prostate cancer does not in itself cause fatigue. CONCLUSIONS: The clinical implications of these findings are that it is not possible to handle new and detailed information about prostate cancer at the first visit. The need for information occurs, however, relatively soon afterwards and it would seem appropriate to offer a new appointment within 1 week of the first visit.
Abstract: The diagnosis and treatment of breast cancer induces adverse effects. In this interpretive phenomenological study, 11 Brazilian women diagnosed and treated for breast cancer were interviewed. Data included audiotaped interviews where the women's lived experiences were articulated. Data were interpreted through Heidegger's existential phenomenology. Themes that were found were interrelated and presented the essential structure of the essence the women were living-living side by side with the phantom of death. The 4 themes that were interpreted and identified were as follows: gaining a positive attitude for life, wanting to be recognized as a woman with certain needs, considering body image/self-image, and making efforts to hide. The findings of the study point out the importance of the fact that illness elicits more than fitting the body into traditional community expectations or surrendering the body to professional medicine. Even with all the deep changes in their lives and changed life priorities, the women want to carry on and live the best life they could. To put this idea in the front line makes the difference for the transition of these women.
Abstract: AIM: This paper is a report of a study to explore different perceptions of psychiatric care among foreign- and Swedish-born people with psychotic disorders. BACKGROUND: Research from different countries reports a high-incidence of psychosis among migrants. The risk-factors discussed are social disadvantages in the new country. To understand and meet the needs of people from different countries, their perspective of psychiatric care must be illuminated and taken into consideration. METHOD: A phenomenographic study was conducted in 2005-2006 using semi-structured interviews with a convenience sample of 12 foreign-born people and 10 Swedish-born people with psychosis. FINDINGS: Three categories were identified: personal and family involvement in care; relating to healthcare staff; and managing illness and everyday life. Foreign-born people differed from Swedish-born people in that they struggled to attain an everyday life in Sweden, relied on healthcare staff as experts in making decisions, and had religious beliefs about mental illness. Among Swedish-born people, the need for more support to relatives and help to perform recreational activities was important. CONCLUSION: It is important to identify individual perceptions and needs, which may be influenced by cultural origins, when caring for patients with psychosis. Previous experience of care, different ways of relating to staff, and individual needs should be identified and met with respect. Social needs should not be medicalized but taken into consideration when planning care, which illustrates the importance of multi-professional co-operation.
Abstract: This phenomenological-hermeneutic study was an inquiry into the lived experience of 16 very old persons who were living in their own homes. The nursing perspective was Gadow's existential advocacy for nursing practice. The study findings led to the essence of the phenomenon: pragmatic transition to old age, within a restricted future. Heideggerian concepts were applied and the findings were discussed in relation to the guiding theoretical perspective and related literature. Understanding the meaning of being a very old person is fundamental to developing nursing interventions to help people remain independent, with a sense of self-determination, for as long as possible.
Abstract: OBJECTIVES: To identify and describe the experience of being a professional patient (PP) in teaching the pelvic examination (PE). DESIGN: Qualitative study using in-depth interviews. SETTING: Participant's home, place of work or other place of choice. POPULATION: Thirteen female PPs who teach the PE to medical students and student midwives. METHOD: Semi-structured interviews analysed with an interpretive phenomenological approach. MAIN OUTCOME MEASURES: Five themes were identified during the analysis: 'embodied knowledge', 'promoting a proper approach', 'redrawing private boundaries', 'feeling confident' and 'doing something meaningful'. The essence 'experience of stronger and clearer perception of self' emerged from the themes and is the described structure of the lived experience of the women who are PP. CONCLUSIONS: Being a PP in this setting was beneficial for the women. They acquired increased knowledge about their bodies and PE procedure, which led to a new awareness of their own body. Contributing to students' learning in such an intimate examination procedure was rewarding and increased self-esteem.
Abstract: BACKGROUND: Women's grief after miscarriage is substantial and important. Women who experience early miscarriage do not constitute a homogenous group. The aim of this study is to measure whether a structured follow-up visit to a midwife (group 1) at 21-28 days after early miscarriage could reduce the women's grief, measured using the perinatal grief scale Swedish short version (PGS) after a further 3 months (i.e. 4 months after the miscarriage), compared to a regular follow-up visit to a midwife (group 2). METHODS: We performed an open randomized study of women who experienced early miscarriage (n = 88). The midwife's attitude in group 1 came from Swanson science theory of midwifery. In group 2, the women were offered only the ordinary type of consultation at a regular visit. A questionnaire with the PGS was used in both groups. Four months after the miscarriage, a second questionnaire with the same perinatal grief scale was sent by post. RESULTS: There was a 30% greater reduction in grief in group 1 than that in group 2, when comparing the first and second measurements (not significant). The biggest differences were in the subscales active grief and difficulty in coping. Women with the subdiagnosis missed abortions had, as a group, significantly higher PGS scores at both visits, especially in active grief and difficulty in coping, regardless of the type of follow-up visit. CONCLUSIONS: A structured follow-up visit did not, in comparison with a regular follow-up visit, imply any significant reduction in grief as measured using the PGS scale. However, the subgroup missed abortion had more extensive grief than the other women with miscarriage. Structured follow-up visits are not imperative for all women with early miscarriage.
Abstract: BACKGROUND: Nursing as a practice-based profession requires that student nurses learn how to become professional in the clinical environment. Many studies have addressed student nurses' clinical learning and related problems, but few have explored the whole clinical experience of being a student nurse. AIM: To understand and gain deeper insight into Iranian student nurses' lived experience of clinical placement. METHOD: Five student nurses were interviewed about their clinical experience during clinical placement. The researchers analysed the verbatim transcripts using van Manen's phenomenological methodology, keeping in mind the recommended six research activities. FINDINGS: Five themes emerged by which the phenomenon of clinical experience could be illustrated. These themes were: caring-orientated relationships, attractive aspects of clinical experience, finding oneself in the clinical milieu, being supportive to classmates, and actualizing potential. Fourteen subthemes expanded and clarified the meaning of these themes. CONCLUSION: The attention paid and acknowledgement given to 'caring' and 'knowledge' by the student nurses showed that they are progressing toward their ultimate goal of being professional nurses. The student nurses' awareness of 'what is going on there?' and also support from other significant people facilitates the students' adaptation process and guarantees this progress.
Abstract: The purpose of this study was to identify the comprehensive picture of palliative care in the home, as experienced by the people involved. The study is a secondary analysis of three phenomenological studies including six cancer patients, six next of kin and six district nurses. Data were collected in qualitative interviews using an interview guide. The interviews were tape-recorded and transcribed verbatim. In this secondary analysis, data were analysed by hermeneutic analysis guided by Gadamer. The guiding questions during the reading were: Is there an advantage receiving palliative care at home? Is there a disadvantage receiving palliative care at home? The findings indicate that the advantages of palliative care at home is; striving for normal life, including the care in the home composed of physical care and emotional/mental care. Striving for normal life also includes emotional feelings, safety and resources and policies which regulates this activity. Disadvantages of palliative care at home are commitment, composed of adaptation and extra work, and demands, composed of frustration and uncertainty. If the people involved are to be able to manage the situation and optimize living while dying, there must be support and resources facilitating the situation.
Abstract: In recent times the rapid expansion of interest in palliative care has become a significant feature of health care development. Caring in the palliative way means simultaneous attention to the medical, nursing, spiritual, emotional, and social needs of the patient. The main purpose of the present study has been to obtain an understanding of patients' experiences of palliative care at home with service from district nurses. The research design is influenced by Giorgi's phenomenology. Six patients diagnosed with cancer and receiving palliative care at home were interviewed and the transcribed interviews were analyzed. Interviews were conducted in the patients' homes. The findings show that the essential meaning of the patients' experiences of palliative home care can be described as "uncertain safety." This meaning of essence is explicated by 4 themes, which are labeled "Safe but unsafe at home," "A sense of powerlessness," "Change of everyday life," and "Hope and belief in the future." The findings of the study point out the importance of well functioning teamwork and resources to facilitate patient's experiences of safety in their own homes. It should be noted that the patient and their next of kin are members of the team.
Abstract: Women who lose an early pregnancy are shocked when they are first given the information that they have miscarried. Later they feel guilt and emptiness. Heideggerian interpretive phenomenology has been used with 13 women from southwest Sweden to uncover their lived experience of miscarriage. Women plan their future with a child during early pregnancy. When miscarriage occurs it is not a gore, an embryo, or a fetus they lose, it is their child. They feel that they are the cause of the miscarriage through something they have done, eaten, or thought. They feel abandonment and they grieve for their profound loss; they are actually in bereavement.
Abstract: BACKGROUND: Living with a genetic predisposition to disease may influence quality of life. The presence of premature disease can lead to an increased focus on family history and genetic predisposition. OBJECTIVE: The purpose of this study was to describe quality of life in patients with the genetic disease, familial hypercholesterolemia, who are at an increased risk of premature coronary heart disease. METHODS: Interviews from 12 adult patients with FH were analyzed using constant comparative analysis. The findings of this qualitative study revealed that for patients, quality of life was equated with harmony in life, the core category. Attaining harmony in life presumes satisfaction and togetherness. Cognizance of the threat of coronary heart disease and impending mortality is balanced by the support of togetherness and satisfaction that builds harmony in life. CONCLUSION: When caring for patients with familial hypercholesterolemia, it is important to meet each patient on his or her own level, and to support balance and their choices for maintaining or regaining harmony in life.
Abstract: Mammography screening is a highly sensitive and specific method to detect breast cancer at an early stage. If screening campaigns are to be cost effective, compliance is valuable. However, many women do not attend when called for mammography screening. Our aim in this study is to understand and explain why women become nonattenders. A sample of 16 nonattending women, aged between 43 and 73 years, participated in this qualitative study, by interviews or written comments. The core category discovered in the data was "getting no respect." The informants did not feel respected from either the society or the health care system. Below this core category, two categories were identified: the mammography examination and affecting circumstances. The performance and its effects comprised the content of the category of mammography examination. The category affecting circumstances included knowledge about risk factors, prevention, and practical or emotional arguments.
Abstract: AIM: To identify and describe expectations, apprehensions and knowledge about the menopausal period and climacteric symptoms. METHOD: Data were collected by semi-structured interviews/discussions with a convenience sample of 39 women, all 47 years of age. Data interpretation and analysis were based on content analysis, but influenced by a qualitative approach. FINDINGS: These included women's expectations and feelings of freedom. Apprehensions were described as different climacteric symptoms, which were well known to the women through their own or other's experiences. The women were, to some extent, aware of the physical and psychological changes that follow the menopause. However, the women lacked knowledge about these changes or self-care activities that could prevent problems or mitigate symptoms. Key conclusions and implications for practice: Discussions on health with premenopausal women can increase their knowledge about a natural phase of life, the climacteric period. The study showed that nurses/midwives who have regular contact with some women during their life have an important role to play in providing information, as well as in the treatment of climacteric symptoms.
Abstract: Primary health care teams are the teams responsible nowadays in Sweden for the greater part of the home health care system, providing palliative care in the patient's home. If palliative care in the home is to be ethically defensible, it should be voluntary from the point of view of the next of kin and should be designed in such a way that he or she receives different forms of support during the care period. The purpose of this paper is to explore the meaning of palliative care in the home as experienced by the next of kin. The data consist of transcripts from interviews with the next of kin. Giorgi's phenomenological method was selected as the method/analysis for this study, because it focuses on uncovering the meaning of experiences of the participants by studying descriptions from their perspective. A feeling of insufficiency is the phenomenon, which permeates all the five themes: adjustment, awareness, being perceived as a person, emotional effects and feelings of uncertainty. Because the informal carer/next of kin is a significant contributor to palliative care in the home, it is important to promote feelings of control and also self-efficacy.
Abstract: BACKGROUND: Caring has been seen as a nursing term/concept, including all the aspects that are used to deliver nursing care to patients. Sometimes caring has been conceptualized as a relational expression of human concern and as a collection of human activities that assists others. AIM: This study is to identify and describe the nature of the concept "caring" from the novice student nurse's perspective. METHODS: A total of 127 Swedish novice student nurses wrote comments in essay form to the question: "what is your image of the concept caring?" Data were analysed using qualitative content analysis, with the use of the theoretical framework: "doing" and "being". FINDINGS: Three categories of caring were identified as "doing", "being" and "professionalism". The phenomena of caring and the caring process could be illustrated as including hand (doing), heart (being) and brain (professionalism). CONCLUSIONS: It is now time to make care more visible as a principle of practice and of moral action. This could be explicit in a clear professional framework and incorporated more fully into nursing education programmes. Caring is to take care of the entire human being physically, emotionally and intellectually. Nurses need to use hand, heart and brain in order to fulfil their commitments.
Abstract: Myocardial infarction is the most common cause of death in Sweden today and is responsible for approximately 30% of all deaths. The aim of this study was to obtain increased knowledge and understanding of what motive power is and how it affects the individual's rehabilitation and return to a functioning daily life. Thirteen patients, six females and seven males, who had experienced a myocardial infarction, aged between 39 and 72 years and with a minimum interval from myocardial infarction diagnosis of at least 12 months, were interviewed. Grounded theory was the method used for data collection and analysis, since the method is focusing on social processes and interaction. The analysis process identified motive power as a core category: zest for life. The participants expressed a desire and a longing to continue living. The participants' experiences of their disease as well as being discharged from hospital forced them to reorientation. Autonomy, the individual's own active decision-making, plays a significant role in this zest for life. Care for was identified as the support base for zest for life. As health-care professionals we must, at a very early stage on the ward, form an idea of what kind of patient we have in front of us.
Abstract: There is a need to understand and explain the impact of breast cancer on women's self-esteem and quality of life. The purpose of the present study was to identify and describe, from the perspective of the women's lived experiences, the impact of breast cancer on women's self-esteem and elucidate its impact on their quality of life. Thirteen women diagnosed as having breast cancer were interviewed about these phenomena. The narrated interviews, tape-recorded and transcribed verbatim were analysed and interpreted using a qualitative text analysis, based on the following question: What sense of satisfaction and importance is there with respect to the women's value and preferences? The findings were interpreted as affected self-respect and self-value, which were found to be important aspects affecting the quality of life of these women, within this lies the satisfaction of desire, to be respected and loved as the women they are. Concerns related to their quality of life seemed to be heightened when treatment has been completed, i.e. when the psychological effects of the treatment experience become a reality. Health professional need to be aware of how to recognise these women, in order to provide them with support to maintain a positive self-esteem to enhance quality of life as a caring outcome.
Abstract: Palliative care describes a caring philosophy. Originally, palliative care referred exclusively to the care of dying cancer patients, but over time has expanded to include mitigating care of all dying people whatever the diagnosis. The purpose of this paper is to explore the meaning of palliative care according to the experience of district nurses in Sweden. Six district nurses were interviewed, and the transcripts were analyzed using Giorgi's phenomenology. The essence of the caring philosophy for the nurses in the study was identified as commitment, underscored by four themes: challenge, control, frustration, and relationships. These findings indicate that district nurses must be offered resources and education in order to be able to fulfill their commitment, i.e., to supply good palliative care.
Abstract: There is an extensive literature on the problem of translating scales for use across cultures, but very little is published on the problems of conducting qualitative interviews in another language with assistance of an interpreter. The aim of this paper is to describe and discuss threats to validity that arise when conducting qualitative interviews using an interpreter. Ten female student nurses in two cities in Lithuania were interviewed about how they perceived their educational program. All interviews were conducted in English with an interpreter. When using an interpreter to conduct interviews, potential threats to validity arise at various points in the interview process. A threat arises when the researcher, whose first language is Swedish, addresses a question in English to the interpreter, another during the translation by the interpreter from English to Lithuanian, and again when the interpreter translates the interviewee's Lithuanian responses to English. In the last situation, the researcher may not know whether the interpreter has summarized and/or modified the responses. To mitigate these problems, the interpreter should not only have the required linguistic abilities, but also be trained in the research field. The researcher has to be aware of these threats to validity and make efforts to meet and limit their effects.
Abstract: Nursing education programmes should be at an academic level and connected to research. In Sweden, empirical studies are generally required in order to obtain a Bachelor's degree; hence, in some cases, these studies are replaced by a literature review. A study was conducted using 11 criteria. Thirteen theses produced in a department of nursing science were examined, elaborated and reproduced by reviewing international and national literature. Thereafter, the criteria themselves were scrutinized. Principal findings when critiquing the theses were that in eight theses the purpose was dearly identified and well defined in relation to the study accomplished; in three theses the purpose was indistinct and vague; and in two the definitions and research questions were lacking. The topic was relevant for the area of nursing in all theses. General problems identified were poor spelling and grammar, and unsatisfactory thesis structure. This article discusses whether criteria are useful when examining the Bachelor candidates' theses. The authors report that the criteria seemed to be useful, giving some guidance for scrutinizing theses and facilitating correspondence. Criteria could be appropriate guidelines for using to increase the quality of the theses as well as the quality of nursing.
Abstract: By means of a simple postal questionnaire, all women registered as hormone therapy patients (n = 241) at a gynaecological clinic were screened for reasons for receiving hormone therapy. They were also screened for their compliance in following the midwife's advice and information, as well as the gynaecologist's prescriptions. The majority of the women participating in this study contacted the clinic for climacteric symptoms. The time duration for using hormone therapy ranged from 1 month to 6 years. Those using a plaster or gel were asked why they should take progesterone pills. Forty per cent gave erroneous answers or did not know. Of these, 62% reported that they understood the oral information, whereas 60% reported that they understood the written information. Fifty-three per cent of the women stated that they would stop their hormone therapy if they did not feel well or increased in weight. New discoveries or information about benefits or risks were given by 22% as reasons affecting their decision. Compliance demands well-motivated and well-informed patients. The implication of the study result for practice is that there must be dialogue between the women and their midwife/ gynaecologist. It is important that the women feel they are receiving treatment which they have given their consent to, and that they feel and know that they are performing self-care. Midwives have recurrent contact with women during their life and have already established a relationship with them, which facilitates an individualized communication.
Abstract: PURPOSE: The purpose of this study was to identify and describe the impact of prostate cancer and its treatment on men's sexuality and intimate relationships from the perspective of the men's lived experiences. DESCRIPTION OF THE STUDY: Ten men diagnosed with prostate cancer were interviewed. Verbal transcripts were analyzed using an interpretive phenomenological approach based on Heidegger's philosophy. RESULTS: "Altered sexual patterns" was identified as the major theme, which in turn was influenced by five minor themes: choice of consequences; age affecting sexual life; hope of improvement; acceptance of altered sexual life; and image of manliness. Choice of consequences showed that survival is paramount, as interviewees often felt that they were choosing between death or sexual dysfunction. Age affecting sexual life identified sexual dysfunction as caused by natural effects of aging. Hope of improvement showed that several men hoped for improvement in sexual function, although it had been years since their treatment. Acceptance of altered sexual life illustrated that the men often felt the need to accept their altered sex life, with their wives playing an important role in this acceptance. Finally, the theme image of manliness showed the men's attempts to acknowledge and cope with the changes in their self-image. CLINICAL IMPLICATIONS: It is important that healthcare professionals adopt a comprehensive approach in communicating information about prostate cancer treatment choices and potential side effects that includes the patient and his partner. Communication and counselling about treatment options, potential side effects, and potential strategies to manage side effects should be offered both at the time of diagnosis and at post-treatment follow-up.
Abstract: AIMS OF THE STUDY: To gain increased knowledge and understanding of what it means to be afflicted with coronary artery disease (CAD) and how it affects the life/lifestyle of the individual. BACKGROUND: Research has documented that education, counselling and behavioural interventions are important elements of cardiac rehabilitation and compliance with treatment. Compliance is generally better with medical treatment than with recommended lifestyle changes. Another influencing aspect is locus of control, i.e. people's own understanding of control is the foundation for the decisions patients make more or less consciously regarding compliance with caring/nursing, treatment and lifestyle changes. METHODS: Eight individuals with diagnosed coronary artery disease were interviewed about their life situation, and the opportunities and obstacles they encountered in making lifestyle changes. These interviews were transcribed and then analysed using a hermeneutic approach. FINDINGS: The findings included three areas: (1) The causes of coronary artery disease describing different factors, such as heredity, lifestyle and demands. (2) Difficulties in the work of rehabilitation, which was explained in terms of informants' feelings of confusion, uncertainty and sadness. (3) Successful rehabilitation consisted of two factors: the personality of the individual patient and external support. CONCLUSIONS: Patients may comply well with follow-up visits but less with lifestyle changes. By identifying different 'characteristics', 'prerequisites' and 'difficulties' that describe patients' compliance, it should be possible to make treatment more individual. Nurses have a significant role in supporting these patients since they are more accessible than physicians. Nurses also have a responsibility to work together with patients to empower them, in order to make their lifestyle changes and self-care activities manageable.
Abstract: For several decades nurses have been using the terms "caring" and "nursing." Caring, considered to be a universal phenomenon, has been seen as a nursing term, including all aspects of delivering nursing care to patients. Ten registered nurses selected from hematologic, oncologic, and lung medicine wards were asked to narrate one situation in which they had been able to supply good caring and one situation wherein they had not been able to provide good caring for the patient. To identify the meaning of the caring phenomenon as experienced and expressed by nurses working with patients who have cancer, a qualitative analysis using phenomenologic hermeneutics was used. The narrated interviews, tape-recorded and transcribed verbatim, were analyzed, and a theme was interpreted: developing and maintaining a helping-trusting interpersonal relationship. Five subthemes also were identified: creating an interaction with the patient and the next of kin, acting to satisfy the needs of the patient and next of kin, feeling frustration in the role of caring, being affected by time aspects, and developing self and acquiring insight. It is in caring that nurses and patients connect with one another, are fulfilled, and experience growth. If they work actively with this perspective, nurses will feel fulfilled, not frustrated.
Abstract: When two or more persons, e.g. nurses and patients, act together interaction takes place. The expectations of nurses and their definition of the patient's illness status affect their behaviour towards the patient and how they practice nursing. The aim of this study was to examine the interaction between adults with leukaemia and their nurses and how this interaction affected the individual. Grounded theory method guided the data collection and analysis. Four adults with leukaemia and their nursing staff were observed for 124 h in a haematological ward. The core category emerging from the data was transition--the individual passing from one phase to another. This denotes a change in role relations, in expectations and in abilities. The individual makes their transition in three stages. First, the person seeks out information in the corridors and at the same time tries to maintain social status. Next, the patient accepts the disease in the confines of their room and feels insecure in a totally new situation and role. Finally, the leukaemia patient isolates themselves within the confines of the bed, and becomes aware of the leukaemia and its side-effects.
Abstract: The person with chronic leukaemia is living with a chronic and life-threatening disease. The aims of this study were to gain a deeper understanding of what individuals with chronic leukaemia consider QOL to be and to give the concept of QOL a theoretical and empirical significance relevant to nursing care. Fifteen adults with different forms of diagnosed chronic leukaemia have been interviewed about their experience of QOL. Verbatim transcripts were analysed using constant comparative analysis. The emerging core category was life satisfaction. Under this construct there were four categories; self-esteem, interpersonal relationships, performance ability and social ability. Changed QOL was described in two ways. First, coping was the core category for living with chronic leukaemia. The strategies were action, denial and hope. Second, QOL was seen as individual perception, experience of a positive attitude to life and self-contemplation.
Abstract: There is a need to understand and explain why quality of life (QOL) is experienced and viewed differently by those with acute and chronic leukemia. A total of 23 adults with either acute or chronic leukemia were interviewed about their experience of QOL. Adults with acute leukemia described QOL as a positive attitude to life, whereas those with chronic leukemia described QOL as life satisfaction. In order to elucidate why there are differences in their experience of QOL, a qualitative text analysis was used. The narrated interviews, tape-recorded and transcribed verbatim, were interpreted based on the following three questions: Why are there differences in these individuals' description of QOL? What are they talking about? Which phenomenon are they describing? The findings were interpreted, "a feeling of uncertainty," which made the difference to their experience of QOL. This uncertainty was expressed in different forms and could be seen in different degrees. Uncertainty is an important factor affecting the QOL of these adults. Nurses who work with these patients have a major role to play in minimizing uncertainty by offering coping skills to deal with feelings and improving QOL since QOL is one of the outcomes of nursing care.
Abstract: Too many children in Sweden grow up under difficult circumstances. Every child should have the opportunity to grow up to be a confident person. We know today that the new-born child is able to influence its surroundings. The main purpose of child health care in Sweden is to reduce mortality, morbidity and disability in children, and also to reduce any detrimental effects on the family. Child Health Care (CHC)-nurses provide community and security for parents and children in developing relationships. The aims of this study were to identify how CHC-nurses view a mother-infant relationship, and how they can improved this relationship. Ten CHC-nurses were interviewed about mother-infant relationships. Verbatim transcripts were analysed using constant comparative analysis. The emerging core category was interplay. Under this construct there were two categories; maternal ability and signals from the infant. Different substantive codes were given under these categories, viz. body language, vocal language, poor health, expectations and life situation. In describing how to improve the mother-infant relationship, promoting an understanding of interplay was the core category. Three categories/strategies were perceived; visualize, respect and demonstrate. The results were then compared with the literature. This study indicates that interplay is of greatest importance in a mother-infant relationship.
Abstract: The cause of acute leukaemia is unknown. Untreated, the disease is generally fatal after a few months. The therapeutic regimen is chemotherapy, and sometimes also bone marrow transplantation, and the aim is to cure the patient. Not only does the person live under pressure from a life-threatening disease with all the physiological complications that therapy can result in, the therapeutic regimen also involves a great psychological effect. The concept of quality of life (QOL) is individual for each person, as is his/her experience of the value of the contents of life. The principal aim of the study was to describe what QOL means to adults with acute leukaemia, not to describe the degree of QOL. The second aim was to give the concept of QOL a theoretical and empirical significance relevant to nursing care. Eight adults with diagnosed acute leukaemia detected in adulthood have been interviewed about their quality of life. The concept was given one superior dimension in all the interviews; positive attitude to life. Below the superior dimension were two further dimensions; interpersonal relationships and autonomy. Different qualities were given below these dimensions, viz. security, support, respect, information and conversation.
