| 11. |
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| 12. |
- Paulson, Margareta, et al.
(author)
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Living in the shadow of fibromyalgic pain : The meaning of female partners' experiences
- 2003
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In: Journal of Clincal Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 12:2, s. 235-243
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Journal article (peer-reviewed)abstract
- The aim of this study was to elucidate the meaning of being a female partner living with a man with fibromyalgic pain. Fourteen partners were interviewed about the meaning of their experiences, using a narrative approach. A phenomenological hermeneutic method, inspired by the French philosopher Ricoeur, was used to interpret the interview text. The structural analysis is presented in three major themes: struggling to give support and comfort, struggling to keep going on, and experiencing lack of understanding and support. The findings elucidate that the meaning of living with a man with fibromyalgic pain meant living a life strongly influenced by the man's illness and in the shadow of the man's pain. Taking daily life for granted was interrupted and restricted family and social life. Prominent in this study was the frustration partners felt as a result of men's reluctance to communicate. This led to feelings of being excluded from men's emotions. The responsibility day in and day out meant that women's own caring and tenderness were replaced, which brought about an almost constant sense of fatigue. Women became drained by the long duration of men's illness. This gave them a feeling of being alone, although they were a couple. Gaining comfort outside the family helped partners to reach a new insight and appreciation for life, which was viewed from a renewed perspective. This involved feelings of both togetherness and separateness in the relationship. The findings also consider the lack of support from the health care system for female partners living with men with fibromyalgic pain.
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| 13. |
- Randers, Ingrid, et al.
(author)
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Confirming older adult patients' views of who they are and would like to be
- 2002
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In: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 9:4, s. 416-31
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Journal article (peer-reviewed)abstract
- This article reveals a 91-year-old cognitively intact man's lived experiences of being cared for in a geriatric context in which the majority of the patients were cognitively impaired. A narrative patient story was analysed phenomenologically. The findings indicate that this patient's basic needs for ethical care were not met. The staff did not see him as a unique individual with his own preferences, resources and abilities to master his life. In order to survive this lack of ethical care, he played the role of an 'old cognitively impaired man', which provided him with at least the understanding and attention the cognitively impaired patients received from the staff. The findings also indicate that ethical care is independent of whether or not older cognitively intact and impaired patients stay or live in the same unit, but it is more dependent on a caregiver's ability to respect and confirm each and every patient for who he or she is and would like to be.
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| 14. |
- Randers, Ingrid, et al.
(author)
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The experiences of elderly people in geriatric care with special reference to integrity
- 2000
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In: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 7:6, s. 503-19
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Journal article (peer-reviewed)abstract
- The aim of this study was to obtain an increased understanding of the experiences of elderly people in geriatric care, with special reference to integrity. Data were collected through qualitative interviews with elderly people and, in order to obtain a description of caregivers' integrity-promoting or non-promoting behaviours, participant observations and qualitative interviews with nursing students were undertaken. Earlier studies on the integrity of elderly people mainly concentrated on their personal and territorial space, so Kihlgren and Thorsén opened up the possibility of considering the concept of integrity from a broader view by recognizing its relationship to the larger framework of the self-concept. Based on this, findings in the present study indicate that elderly people's integrity relating to their corporal self were the least violated. On the other hand, their psychological, information and cultural selves were the most exposed. The study also identified a further dimension (i.e. one relating to social self), which should be included in the concept of integrity because respecting elderly people's social self reduces their feelings of loneliness, isolation and seclusion. In summary, the results indicate that the concept of integrity is complex and has several dimensions.
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| 15. |
- Runeson, Ingrid, et al.
(author)
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Children’s Participation in the Decision-Making Process During Hospitalization: an observational study
- 2002
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In: Nursing Ethics. - : SAGE Publications. - 1477-0989 .- 0969-7330. ; 9:6, s. 583-598
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Journal article (peer-reviewed)abstract
- Twenty-four children (aged 5 months to 18 years) who were admitted to a university hospital were observed for a total of 135 hours with the aim of describing their degree of participation in decisions concerning their own care. Grading of their participation was made by using a 5-point scale. An assessment was also made of what was considered as optimal participation in each situation. The results indicate that children are not always allowed to participate in decision making to the extent that is considered optimal. In no case was it judged that a child participated in or was forced to make a decision that was too difficult for the child. The interactions between children, parents and staff were also described in connection with discussions and decision-making processes. This showed that parents do not always support their children in difficult situations and that health care staff often inform children about what is going to happen without presenting alternatives or asking for their views. Staff may, however, find themselves facing an ethical conflict in deciding between supporting a child’s view or following hospital routine. It is of great importance that children are looked upon as potentially autonomous individuals and that staff members realize that one of their core duties is to facilitate children’s participation in decision making concerning their health care.
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| 16. |
- Sahlberg-Blom, Eva, et al.
(author)
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Patient participation in decision making at the end of life as seen by a close relative
- 2000
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In: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 7:4, s. 296-313
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Journal article (peer-reviewed)abstract
- The aim of the present study was to describe variations in patientparticipation in decisions about care planningduring the final phase of life for a group of gravely ill patients, and how the different actors’manner of acting promotes or impedes patientparticipation. Thirty-seven qualitative research interviewswere conducted with relatives of the patients.The patients’ participation in the decisionscould be categorized into four variations: self-determination,co-determination, delegation and nonparticipation.The manner in which patients, relatives andcaregivers acted differed in the respective variations; thisseemed either to promote or to impede the patients’opportunities of participating in the decisionmaking. The possibility for participation seems to be context dependent and affected by many factors suchas the dying patient’s personality, thesocial network, the availability of different forms of care,cultural values, and the extent to which nursesand other caregivers of the different formsof care can and want to support the wishes of the patients andrelatives in the decision-making process.
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| 17. |
- Sjöstedt, E, et al.
(author)
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The first nurse-patient encounter in a psychiatric setting : discovering a moral commitment in nursing.
- 2001
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In: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 8:4, s. 313-27
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Journal article (peer-reviewed)abstract
- The aim of this study was to deepen nurses' understanding of the importance of carefully managing the first nurse-patient encounter in a psychiatric setting according to each patient's suffering and future hopes. The study was carried out using an action research approach. The action planned was the implementation of a conceptual model reflecting Eriksson's caring theory. Data were collected by interviews with nurses and observational notes kept in a research diary. The data analysis followed the procedure of qualitative content analysis. A generalization of the entire learning process shows the first nurse-patient encounter to be a moral commitment in nursing. A theoretical framework of nursing assessment conveying knowledge about the patient as unique and being a whole person can support the nurse in encouraging the patient to enter into a relationship. This insight stimulated the nurses in this study to reflect on the moral responsibility of continuing the relationship and initiating an ongoing nursing process. Awareness of this responsibility made them reflect more on the possibility of nurses taking autonomous actions in order not to abandon the patient and to avoid feeling guilty.
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| 18. |
- Svedberg, B, et al.
(author)
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The morality of treating patients with depot neuroleptics: the experience of community psychiatric nurses
- 2000
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In: Nursing ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 7:1, s. 35-46
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Journal article (peer-reviewed)abstract
- The aim of this qualitative study was to gain an understanding of the meaning that community psychiatric nurses impart to their everyday interactions with patients in depot neuroleptic treatment situations. Nine experienced community psychiatric nurses were interviewed using semistructured, open-ended questions. Data analysis was by the phenomenological descriptive method according to Giorgi. Four themes were identified, highlighting aspects of the moral meaning of treating patients with depot neuroleptics: (1) ‘benevolent justification’ occurs when nurses perceive that the patient’s welfare is at stake; (2) ‘inability to advocate the patients’ best interest’ occurs when nurses feel they are at a disadvantage; (3) ‘accommodative interactions’ occur when nurses are able to respond to a patient’s expressed needs; and (4) ‘acceptable advocacy’ occurs when physicians are sensitive to nurses’ suggestions on patients’ treatment. The findings indicate that treatment care planning involving both patients and nurses is essential to enhance patients’ autonomy, which is a precondition for satisfactory interactions. This phenomenological study describes the meaning that nurses give to administering depot neuroleptic injections to patients in the context of community psychiatric clinics. The phenomenon of concern was identified as the moral aspect in the interactions with individual patients in the treatment situation.
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| 19. |
- Sørlie, Venke, et al.
(author)
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Meeting ethical challenges in acute care work as narrated by enrolled nurses.
- 2004
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In: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 11:2, s. 179-88
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Journal article (peer-reviewed)abstract
- Five enrolled nurses (ENs) were interviewed as part of a comprehensive investigation into the narratives of registered nurses, ENs and patients about their experiences in an acute care ward. The ward opened in 1997 and provides patient care for a period of up to three days, during which time a decision has to be made regarding further care elsewhere or a return home. The ENs were interviewed concerning their experience of being in ethically difficult care situations and of acute care work. The method of phenomenological-hermeneutic interpretation inspired by the French philosopher Paul Ricoeur was used. The most prominent feature was the focus on relationships, as expressed in concern for society's and administrators' responsibility for health care and the care of older people. Other themes focus on how nurse managers respond to the ENs' work as well as their relationships with fellow ENs, in both work situations and shared social and sports activities. Their reflections seem to show an expectation of care as expressed in their lived experiences and their desire for a particular level and quality of care for their own family members. A lack of time could lead to a bad conscience over the 'little bit extra' being omitted. This lack of time could also lead to tiredness and even burnout, but the system did not allow for more time.
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| 20. |
- Talseth, Anne-Grethe, et al.
(author)
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Struggling to Become Ready for Consolation : experiences of suicidal patients
- 2003
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In: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 10:6, s. 614-623
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Journal article (peer-reviewed)abstract
- Although there has been a vast amount of research about suicide, very few studies focus on the inner world of the suicidal patient. A secondary analysis of two exemplar narrative interviews with Norwegian patients reveals a glimpse of the inner world of suicidal patients’ longing for consolation. The results of a phenomenological hermeneutic study inspired by Ricoeur’s philosophy reveal five themes and one main theme. The themes are: ‘longing for closeness’, ‘desiring connectedness’, ‘struggling to open up inner dialogue’, ‘breaking into outer dialogue’, and ‘liberating inner and outer dialogue’. The main theme is ‘struggling to become ready for consolation’. These results describe a process of becoming ready for consolation, which, when interpreted in the light of the model of consolation by Norberg et al., reveals that the end of the process of becoming ready for consolation is consolation itself as praxis.
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