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

DEF – Det existentiella förbandet – betydelsen av medkänsla i omhändertagande efter katastrof

Medkänsla, medlidande och universell eller ontologisk gemenskap mellan människor har framträtt som avgörande för en hälsosam utveckling efter upplevelser av katastrof. Början till en handlingsmodell kallad ”DEF – Det existentiella förbandet” (som en fortsättning på ABC) finns i en nyutkommen bok (1). Den utgår från att livsfrågor är en betydelsefull del av långtidsuppföljningen efter en katastrof. ”Livsfrågor” är de existentiella frågorna om livets innehåll, om värden, prioriteringar, människors förhållande till varandra och betydelsen av hälsa, lidande, kärlek och död. Livsfrågor innebär också livsförståelse och att förstå livet på nytt efter en katastrof. Bearbetning av livsfrågor förutsätter mänsklig gemenskap. Ett existentiellt omhändertagande bygger på en medmänsklig hållning av medkänsla och naturlig människokärlek. Vi föredrar i enlighet med vår vetenskapliga tradition att på svenska även tala om fenomenet medlidande som svar på medmänniskans lidande (engelska ”compassion”)

The meaning of consolation as experienced by nurses in a home-care setting

Aims and objective. The aim of this study was to illuminate nurses’ experiences ofconsolation and how these experiences relate to suffering and care.Background. Consolation is commonly associated with the relief of suffering. Thequestion of consolation in terms of its definition and relevance for care has, however,been a matter of discussion among nurse researchers. The question raisedconcerns about the nature of consolation, its place and its role in relation to care andthe caring sciences.Design. An explorative qualitative interview study with 12 participants, six registeredand six enrolled nurses, was carried out in a home-care context.Methods. A phenomenological-hermeneutic method inspired by the French philosopherPaul Ricoeur was used for the text analysis.Results. Two main aspects of consolation appeared: ‘the present consolation’, whichis flexible, sustaining and opening and ‘the absent consolation’, which conceals thesuffering and is incapable of consoling. The result was interpreted from a philosophical-ethical perspective, based on the works of Levinas and Lo¨ gstrup.Conclusions. Consolation appears as a complex phenomenon, both in terms of itsexistence and its absence consolation, constituting a caring and non-caring consolation.A caring consolation entails meeting the other as different and being presentin a way that gives the other space to be the one he or she really is. It requiresacceptance, accepting the sufferer and his/her way of suffering as unique

Embodied reflection in practice-Touching the core of caring

A study was performed with the aim of clarifying the integration of the caring act of touch with reflection on caring theory. Seven participant nurses in elderly care volunteered as coresearchers and performed a caring act called Rhythmical Embrocation, together with reflective dialogues on caring theory. The project lasted for 6 months and at the end qualitative interviews with participants were used to evaluate the study. The findings showed an opening of awareness, embodied moments of presence and an extended ability to act creatively in caring. In this study, the movement between theory and practice was the integration of the caring act with reflection on basic caring concepts. Implications for praxis development are that implementation and reflection by teams over certain caring acts might open the door to an expanded view of ones own caring ability that in the long run will benefit the patient.This is the pre-reviewed version of the following article:Albertine Ranheim, Anita Kärner, Maria Arman, Arne Wilhelm Rehnsfeldt and Carina Berterö, Embodied reflection in practice-Touching the core of caring, 2010, International Journal of Nursing Practice, (16), 3, 241-247.which has been published in final form at: http://dx.doi.org/10.1111/j.1440-172X.2010.01836.xCopyright: Blackwell Publishing Ltdhttp://eu.wiley.com/WileyCDA/Brand/id-35.html</p