Fatherhood as Taking the Child to Oneself: A Phenomenological Observation Study after Caesarean Birth

This paper describes the meaning of a father’s presence with a full-term healthy child delivered by caesarean section, as observed during the routine post-operative separation of mother and child. Videotaped observations recorded at a maternity clinic located in the metropolitan area of Stockholm, Sweden formed the basis for the study, in which fifteen fathers with their infants participated within two hours of elective caesarean delivery in the 37th - 40th week of pregnancy. A phenomenological analysis based on Giorgi’s method was conducted on the data. The description of the new father’s experiences that emerged pointed to a process of being and becoming in taking the child to himself. Fatherhood developed gradually as a result of recurrent experiences of the child’s expressions. There was an ebb and flow between taking on the role of being a father and physical withdrawal from the role. The findings of this study not only confirm previous accounts of new fathers’ experiences, but go further in revealing an ebb and flow variation in the fathers’ involvement. What this indicates is that the process of transition to fatherhood requires not only presence but time. The period required for this process thus must not be disturbed, but supported, trusting in the father’s ability to assume his role as a father. It is suggested that, in addition to their relevance in guiding the attitudes and expectations of those professionally involved in postnatal care and community health, these findings could be useful in antenatal courses for parents, and especially in instances when caesarean birth is planned, to highlight the meaning of the role of fathers as caregivers. Indo-Pacific Journal of Phenomenology, Volume 6, Edition 2 August 200

Struggling for existence—Life situation experiences of older persons with mental disorders

Older persons with mental disorders represent a vulnerable group of people with extensive and complex needs. The older population is rapidly increasing worldwide and, as a result of deinstitutionalization in mental health care, older persons are remaining at home to a greater extent. Although they constitute a large proportion of the population, older persons with mental disorders have been neglected in research as well as in care organizations. As there is little previous knowledge concerning older persons’ experiences of their own situations, this study aimed to illuminate the meaning of the life situation as experienced by older persons with mental disorders (excluding dementia disorders). Interviews were conducted with seven older persons and the text was analyzed using a phenomenological hermeneutical research method, inspired by the philosophy of Paul Ricoeur. “Struggling for existence” emerged as a main theme in the older persons’ narratives, understood as a loss of dignity of identity and involving being troubled and powerless as well as yearning for respect. The older persons fought to master their existence and to be seen for who they are. The study highlights the importance for caregivers, both formal and informal, to avoid focusing on the diagnoses and rather acknowledge the older persons and their lifeworld, be present in the relation and help them rebuild their dignity of identity. This study brings a new understanding about older persons with mental disorders that may help reduce stigma and contribute to planning future mental health care

Attitudes of nurses and student nurses towards working with older people and to gerontological nursing as a career in Germany, Scotland, Slovenia, Sweden, Japan and the United States.

The aim of this study was to describe attitudes towards caring for older people among nurses and student nurses in six participating countries. Working with older people has historically had a negative profile and, with a global rise in the numbers of older people and a global shortage of nurses, it is essential to recruit nurses into this area. This study gathered data from six countries to explore nurses' and student nurses' attitudes to nursing older people and to gerontological nursing as a career. A convenience sample of 1064 nursing students and 2585 nurses in six countries answered the Multifactorial Attitudes Questionnaire (MAQ), designed to elicit attitudes towards caring for older people and to the esteem that comes with working in this field. The MAQ consists of seven positive and thirteen negative statements, and uses a Likert scale. A higher total score indicates a more positive attitude. Differences in attitudes among the six counties was observed for both nursing students and for nurses ( < 0.001). Nursing students in Scotland and the USA had the highest mean scores, and Slovenia and Sweden were the countries with the lowest mean scores. The highest scores for nurses were reported in Scotland and Sweden, and the lowest scores in Germany and Japan. From the findings, it is suggested that formal nursing education to students between 18 and 29 years of age has high importance for positive attitudes towards working with older people

Care of the old—A matter of ethics, organization and relationships

The world stands on the threshold of a demographic revolution called global ageing. According to the World Health Organization (WHO), the population aged 60 and over is expected to increase from today's 650 million to an estimated 2 billion by 2050. Alongside demographic changes, dramatic changes can also be observed in older people's services. The shift has resulted in reduced government spending on caring for ill and frail older people in health care. Today, many governments have developed strategies to keep older people living well in their private home for as long as possible and have replaced long-term care institutions with residential homes. The aim of this study was to illuminate the meaning of caring for older people as experienced by health care students and professionals working in this field. Interviews were carried out with 17 women and one man, aged 21–65 years; six were Registered Nurses (RN), six were Enrolled Nurses (EN) and six were nursing students. The interviews were analyzed with a phenomenological hermeneutical approach and provided three themes and eight sub-themes: Ethical moral self with sub-themes “meeting the needs of the old”, “pliability towards the old”, and “difficulties in meeting aggressiveness”; Organizational and co-workers ethical moral actions with sub-themes, “co-workers who are offensive”, and “supportive and non-supportive leaders”: The relation with the old persons and their relatives with sub-themes “fellowship and closeness in the relation”, “uncertainty and fear in the relation”, and, “demands from the older persons’ close relatives”

The encounter with the unknown: Nurses lived experiences of their responsibility for the care of the patient in the Swedish ambulance service

Registered nurses (RNs) have, according to the Swedish National Board of Health and Welfare, the overall responsibility for the medical care in the ambulance care setting. Bringing RNs into the ambulance service are judged, according to earlier studies, to lead to a degree of professionalism with a higher quality of medical care. Implicitly in earlier studies, the work in the ambulance service involves interpersonal skills. The aim of this study was to describe RNs' experiences of being responsible for the care of the patient in the Swedish ambulance service. A reflective lifeworld approach within the perspective of caring science was used. Five RNs with at least five years experience from care in the ambulance care setting were interviewed. The findings show that the essence of the phenomenon is to prepare and create conditions for care and to accomplish care close to the patient. Three meaning constituents emerged in the descriptions: prepare and create conditions for the nursing care, to be there for the patient and significant others and create comfort for the patient and significant others. The responsibility is a complex phenomenon, with a caring perspective, emerging from the encounter with the unique human being

Nursing students' narrated, lived experiences of caring, education and the transition into nursing, focusing on care of the elderly

Fagerberg, I. Nursing students' narrated, lived experiences of caring, education and the transition into nursing, focusing on care of the elderly. Doctoral dissertation. Department of Clinical Neuroscience and Family Medicine, Division for Geriatric Medicine, and Center of Caring Sciences South, Karolinska Institute, Stockholm. Correspondence: Mälare Valley University College, Department of Caring Sciences, P. O. Box 883, S-721 23 Västerås, Sweden.1998; ISBN 91-628-2894-0. The overall aim of this longitudinal research project was to elucidate and reach an understanding of influencing aspects on nursing students' choice of future work area as newly graduated nurses. The influencing aspects should be affiliated with the three-year education, the students' transition into nursing and the care of the elderly. The first study (I) concerned the amount of projected education in gerontology and geriatrics in 30 colleges of nursing and health, and the result showed a variety between colleges. Newly admitted nursing students in three colleges responded to a questionnaire. A majority of the students preferred to work in the emergency care, rather than elder care, after graduation. Phenomenological analyses of one interview theme, after one year (II), gave two phenomena; patients' helplessness and identification/nonidentification of the individual patient. Phenomenological hermeneutic analyses were carried out on all interviews and diaries provided from the three years (III-V). The findings (III) show that the rneaning of caring for elderly patients was a process from naive caring via deeper relationships with patients to an organizational perspective. The transition into nursing (IV) meant for the students a process from a natural interest in caring to the perspective of an RN, where co-operation with team members had a strong influence. The students' experiences of theoretical and clinical elder care were not positive, which meant that their reluctance to work there was reinforced (V). Content analyses about students' reasoning regarding two fictitious elderly patient cases (Vl) showed a development in reasoning in a more acute oriented case but not in a case with a confused elderly patient. Conclusions drawn imply that both the theoretical and the clinical education in gerontology and geriatrics need to be strengthened. Key words: nursing students, elder care, longitudinal study, caring, transition into nursing, nursing education

Developing Concepts in Caring Science Based on a Lifeworld Perspective

Concept development is a significant form of inquiry to expand and develop the knowledge base in caring science. The authors’ aim in this article is to illuminate the possibility of working with concept development, based on a life world perspective, especially Merleau-Ponty’s philosophy of language, wherein phenomenological, semiological, and pragmatic dimensions are included. The theoretical discussion shows that it is possible to create methodological principles for concept development based on epistemological foundations that are consistent with ontological assumptions in caring scienc

Attitudes towards older people among Swedish health care students and health care professionals working in elder care

The proportion of older people in the general population has increased and will continue to increase during the coming decade. Therefore, a positive attitude towards older people is important. The aim of the study was to gain knowledge about attitudes towards older people among health care students and health care staff in Swedish elder care settings. The study includes a convenience sample of 928 respondents comprised of health care students and three groups of professional caregivers [registered nurses (RNs) with university degrees, certified nursing assistants (CNAs), nurses] in a variety of health care settings in Sweden. The participants completed the Kogan&rsquo;s Old People (KOPS) Scale with 17 positive (OP+) and 17 negative (OP&ndash;) statements. The statements score ranged from 17 to 85 respectively. A significant (P&lt;0.05) difference in both positive and negative scores was observed among the three professional caregiver groups. RNs had the highest positive score (OP+:64) as well as the lowest negative score (OP&ndash;:36). Health care students in semester one had the most unfavourable attitude toward older people (OP&ndash;:41) while students in semester two had the most favourable attitude toward older people (OP+:62). RNs reported both a higher positive score as well as lower negative score compared to nurses without an academic degree and CNAs. In addition, we found that progression in one&rsquo;s health care education contributes to reduce unfavourable attitudes toward older people. Health care professionals need to have the right skills to manage a more demanding role in the future in order to offer effective services for older people. A skilled workforce of health professionals is therefore very necessary

Learning to live with diabetes : integrating an illness or objectifying a disease

Aim: This paper is a report of a study of illuminating the meaning of ‘learning to live with diabetes’ 3 years after being diagnosed. Background: A changed situation, for example, in relation to living with diabetes, raises a need to understand. How time for experience contributes to this learning process for people living with diabetes is not yet well understood. It would therefore seem valuable to ask people, who have had diabetes over a similar length of time, to narrate their experience in relation to daily life situations in order to understand better how learning is established. Design: The study has a qualitative design. Methods: A life world approach was used, with interviews being conducted with 13 people who had been diagnosed with diabetes 3 years earlier. Data were collected in 2007, and analyses were conducted using a phenomenological-hermeneutic method. Findings: How a person experiences the physical body was found to be crucial in the learning process. If the body with its signals is understood it can be a tool for experiencing and understanding the world and oneself. Feeling insecure about one’s own needs, and not trusting or understanding bodily signs, made participants dependent on others to make decisions for them. Conclusion: This study showed that duration of illness was ‘not’ of importance for the understanding of living with diabetes. Living with diabetes 3 years after being diagnosed meant to experience both an overall balance in one’s existence and a daily struggle.Part of both Licentiate Theses and Doctoral Theses.Title in Licentiate Theses: Learning to live with diabetes : a balance or a struggle in the lived bodyPublication status in Licentiate Theses: Submitted</p