The battle between hoping and suffering : a conceptual model of hope within a context of spinal cord injury

The aim of this longitudinal study was to explore 10 patients’ experiences of the meaning they attribute to the substance of hope and the process of hoping during the first 3 to 4 years following a spinal cord injury. This qualitative study is a synthesis of three empirical studies of hope and the overall aim was to deepen the understanding of the phenomenon of hope, based on the text representing the main contextual findings, to develop a theoretical framework on hope within a context of spinal cord injury, illustrated in the conceptual model. In correspondence with Ricoeur, this conceptual model, which was developed from a new understanding, based on a new text of the phenomenon of hope, develops a new and deeper understanding of the meaning of hope. Findings revealed 9 themes: universal hope, uncertain hope, hope as a turning point, the power of hope, boundless creative and flexible hope, enduring hope, despairing hope, body-related hope, and existential hope. The conceptual model was derived from these themes, illustrated as The Battle between Hoping and Suffering and The Road of Hope. The interpretations also revealed a distinction between being in hope and having hope, and having a hope of improvements was the main focus at the early stage of rehabilitation, whereas being in hope as being just fine was the main focus after 3 to 4 years of rehabilitation. Key words: conceptual model on hope, despair, longing, suffering, vicious cycl

Dignity in relationships and existence in nursing homes’ cultures

Introduction: Expressions of dignity as a clinical phenomenon in nursing homes as expressed by caregivers were investigated. A coherence could be detected between the concepts and phenomena of existence and dignity in relationships and caring culture as a context. A caring culture is interpreted by caregivers as the meaning-making of what is accepted or not in the ward culture. Background: The rationale for the connection between existence and dignity in relationships and caring culture is that suffering is a part of existence, as well as compassion in relieving suffering, and ontological interdependency. Aim: To describe different expressions of dignity in relationships and existence in context of caring cultures from the perspective of the caregivers. Research design: The methodology and method are hermeneutic. The method used was to merge the theoretical preunderstanding as one horizon of understanding with empirical data. Participants and research context: Focus group interviews with caregivers in nursing homes. Ethical considerations: The principles of the Helsinki Declaration have been followed to, for example, preserve self-determination, integrity, dignity, confidentiality and privacy of the research persons. Findings: Data interpretation resulted in four themes: Encountering existential needs that promote dignity in a caring culture; To amplify dignity in relationships by the creative art of caring in a caring culture; Violation of dignity by ignorance or neglect in a non-caring culture and The ethic of words and appropriated ground values in a caring culture. Discussion: Dignity-promoting acts of caring, or dignity-depriving acts of non-caring are adequate to see from the perspective of dignity in relationships and existence and the caring culture. Conclusions: Dignity in relationships seems to touch the innermost existential life, as the existential life is dependent on confirmation from others.publishedVersio

Family Caregivers' Experiences in Nursing Homes: Narratives on Human Dignity and Uneasiness

This qualitative study focused on dignity in nursing homes from the perspective of family caregivers. Dignity is a complex concept and central to nursing. Dignity in nursing homes is a challenge, according to research. Family caregivers are frequently involved in their family members’ daily experiences at the nursing home. Twenty-eight family caregivers were included in this Scandinavian cross-country, descriptive, and explorative study. A phenomenological-hermeneutic approach was used to understand the meaning of the narrated text. The interpretations revealed two main themes: “One should treat others as one would like others to treat oneself” and “Uneasiness due to indignity.” Dignity was maintained in experiences of respect, confidence, security, and charity. Uneasiness occurred when indignity arose. Although family caregivers may be taciturn, their voices are important in nursing homes. Further investigation of family caregivers’ experiences in the context of nursing homes is warranted

Maintaining dignity in vulnerability : A qualitative study of the residents' perspective on dignity in nursing homes

Author's accepted version (post-print)

Dignity and existential concerns among nursing homes residents from the perspective of their relatives

Aims and objectives: The aim of this cross-country Scandinavian study was to explore how residents in nursing homes experience that their dignity is promoted and attended to. This is one part of the Scandinavian project in which we interviewed residents, relatives and staff members. Background: The main subject concerns the dignity of residents of nursing homes for older people. This article brings forward results from interviews of relatives on how they experience that the dignity is met, promoted and attended to for their next of kin. Design: The study was qualitative with a hermeneutic approach. Methods: Qualitative research interviews of 28 relatives of residents at six participating nursing homes in Scandinavia. The results derive from analysis of the interviews using Kvale’s three levels of interpretation; self-understanding, common sense and a theoretical understanding. Results: The following themes emerged, from the perspective of the relatives, concerning what was deemed important to the resident according his existential needs and concerns: a). To have a comfortable, homely and practical room. b). To have close contact with family, friends and with the staff. c). To have aesthetic needs and concerns attended to. d). To have ethical needs and intrinsic values attended to. e). To have cultural and spiritual needs and concerns attended to. Conclusion: The results provide more substance to the theme and are all important in terms of the residents’ feeling of worthiness and dignity. In general it seemed that the relatives experienced a positive encounter with the staff, but it was also mentioned that staff members were not confronted about episodes that were undignified and disgraceful. This could be a sign or expression that they were worried that negative responses or complaints could lead to a kind of reprisal against the resident and to indignit

The significance of meaningful and enjoyable activities for nursing home resident’s experiences of dignity.

Author's accepted version (post-print).This is the peer reviewed version of the following article: Slettebø, Å., Sæteren, B., Caspari, S., Lohne, V., Rehnsfeldt, A.W., Heggestad, A.K.T., ... Nåden, D. (2016). The significance of meaningful and enjoyable activities for nursing home resident’s experiences of dignity. Scandinavian Journal of Caring Sciences, which has been published in final form at http://dx.doi.org/10.1111/scs.12386

Human dignity research in clinical practice : A systematic literature review

Background This literature study describes caring science research on human dignity in different clinical practice. We already know a good deal about human dignity in nursing care but how do patients, nurses, healthcare professionals and next of kin experience human dignity in clinical practice? Aim To summarise studies on human dignity to gain a deeper understanding of how it can be achieved in caring science research and to gain a broader understanding of the differences and similarities across caring contexts. The aim was also to gain a broader understanding of the differences and similarities of human dignity across different clinical practice. Method The literature review re-analysed 28 empirical studies on human dignity are experienced from acute, psychiatric, elderly and rehabilitation care. The data analysis strategy was conducted in a systematic and critical way and consisted of a five-step method. Result Maintaining dignity was described when caregivers had the time and the will to see and listen to patient and had the courage to see what they did not want to see, allowing their inner powers to act with the purpose of doing good. In elderly care, it was important that elderly persons are involved as members of society and experience respect, confidence, security and charity. Indignity was described when caregivers did not allow patients to have their will and when they had unethical attitudes, ignoring patients and creating powerlessness. The feeling of being abandoned and not being taken seriously are also described in elderly care. Conclusion Findings show how caregivers fulfil their ethical responsibility by seeing, listening and being a part of the time and place. The will to do good includes the courage to preserve dignity and human value rests on being created as a human being. More research is needed about ethical and moral responsibility in clinical practice

Helsevesenet trenger vår kompetanse- hvorfor ikke bruke den? En kvalitativ studie av filippinske sykepleieres opplevelse av veien til autorisasjon i Norge

The healthcare system need our competence - why not use it? A qualitative study of Filipino nurses experience of their way to accreditation in Norway Healthcare professionals educated outside the EU/EEA are an important source of labor in the Norwegian healthcare system, where nurses and auxiliary nurses from the Philippines constitute the largest group. Complicated authority requirements are attached to accreditation in Norway. The study explores how Filipino nurses with three different approvals in the authorization process, experience the process of accreditation in Norway, using qualitative research interviews. The results show that nurses face challenges related to the authorization process in Norway, which they experience as unworthy, unfair, baffling and economically burdensome, but also with experiences of hope for good prospects. A predictable and a dignified authorization process for Filipino nurses should be developed, so that their knowledge and competence can be included and appreciated in the Norwegian health care services

"Helsevesenet trenger vår kompetanse-hvorfor ikke bruke den?"En kvalitativ studie av filippinske sykepleieres opplevelse av veien til autorisasjon i Norge

Internasjonal sykepleiemigrasjon har vært økene de siste 15 årene og alt tyder på at det vil fortsette inn i framtiden (Debesay og Tschudi-Madsen, 2018). I dagens norske helsevesen er det underskudd på 2500 autoriserte sykepleiere, og beregninger viser at underskuddet vil, parallelt med et økende omsorgsbehov, være mer enn tidoblet innen 2035 (Samfunnsøkonomisk analyse, 2018; Gautun, 2016). Sykepleiere og helsefagarbeidere utdannet på Filippinene er den største kilden til arbeidskraft fra land utenfor EU/EØS i Norge, og de er et viktig bidrag for å dekke nevnte omsorgsbehov. I dag bor det 21.283 filippinske innvandrere i Norge (SSB, 2018) og i 2017 var 1808 helsefagarbeidere fra Filippinene sysselsatt i norsk helsevesen. Sansynligvis er de fleste helsefagarbeidere utdannet sykepleiere og ifølge Helsedirektoratet, et ubenyttet kompetansepotensiale (NHSP 2020-2023). I 2017 var det i Norge sysselsatt 946 sykepleiere fra Filippinene, og disse utgjorde den tredje største gruppen av utenlandske sykepleiere, etterfulgt av Sverige og Danmark. Imidlertid viser studier at migrasjon av sykepleiere kan skape utfordringer både i landet sykepleiere reiser fra og i landet sykepleiere reiser til (Delucas, 2014; Ortiga, 2014; Moyce, Lash, & de Leon Siantz, 2016). En sentral problemstilling i denne sammenheng er utfordringer knyttet til sykepleiernes autorisasjonsprosess, når en sykepleier er utdannet i ett land og skal utøve sin profesjon i et nytt land. Samtidig må alt helsepersonell ha autorisasjon for å utøve sitt yrke, noe som er viktig for pasientsikkerhet og for at befolkningen skal ha tillit til helsevesene