Dignity in fragile older women receiving daily municipality care

Background:Dignity is an important ideal in the nursing of older women who need municipal care. Dignity can be challenged when health is impaired by feeling grief and suffering associated with bodily changes and impaired functions. Aim and research questions:The study aimed to deepen the understanding of the meaning of dignity in the life of fragile older women who daily needed help from municipal care service. The research questions are: What is older women’s experience of dignity, and what is it not to be met with dignity when needing service from municipality care? Research design: The study has a qualitative design, and the methodology is based on Gadamer’s ontological hermeneutics. Ten women receiving municipal care, aged from 66 to 91 were interviewed in their home environments. Kvale and Brinkmanns’ three levels of interpretation were applied in the analysis of the interviews: self-understanding, a critical understanding based on common sense, and theoretical understanding. Ethical considerations: The study follows the guidelines for good scientific practice according to the Declaration of Helsinki and was approved by the Norwegian Centre for Research Data. Results: The interviews revealed fragments of the women’s unique life history. Two themes emerged from the interpretation: Confirming encounters provide human dignity; and Not being confirmed as a human being violates human dignity. Conclusions:For the women, dignity is about feeling seen and understood by the individual nurse and this takes place both in conversation and in bodily care. Not being seen or confirmed gives rise to suffering. The reason for this seems to be lack of competence on the part of the staff or little continuity.publishedVersio

Multi-professional ethical competence in healthcare – an ethical practice model

Introduction The starting point is that ethical competence is the basis for ethical healthcare practices and quality of care. Simultaneously, there is a need for research and development from a holistic multi-professional perspective. Aim The aim is to create a proposed model for multi-professional ethical competence grounded in clarified meanings and dimensions of ethical competence studied from a multi-professional healthcare perspective. The research questions are, what is ethical competence from a multi-professional healthcare perspective and what strengthens a multi-professional ethical healthcare practice? Research design The research has a qualitative approach and hermeneutic application research design. Two groups with six participants from clinical practice and two scientific researchers in each group met four times for dialogue. Thematic analysis was used as an analysis method. Ethical considerations The research is approved by the Declaration of Helsinki, the General Data Protection Regulations, and ethical permission was asked from the Norwegian Centre for Research Data (NSD). Results The proposed model for multi-professional ethical competence encompasses a three-dimensional ethical value base that is underpinned by: Ethical attitude – a personal desire to do good; Ethical basis – the best for the patient as a common goal and Ethical culture – common goals and values in the organization. Multi-professional ethical competence is strengthened by: Reflection – to see with new wondering eyes; Time for talk – interdisciplinary teamwork and Leadership – an ethical role model and support. Discussion Ethical competence has a strong link to the core of caring ethics and a deeper personal value base and attitude. Ethical competence involves the whole culture and is seen as a shared value base and a responsibility to do the best for the patient as a multi-professional team and organization. Ethical competence becomes active in healthcare practice by opening up for meaningful multi-professional talks and reflections.publishedVersio

Møtet – å se og bli berørt av pasienten: En grunn for etisk kompetanse hos helsepersonell

The purpose of this caring science study is to deepen the understanding of health personnel’s experiences of challenges and the fundamental basis for maintaining ethical competence in clinical practice. The study has a qualitative design. The methodology is hermeneutic application research. Twelve participants from several professions were divided into two groups for dialogue and reflection about ethical competence. Systematic text condensation was used as an analysis method.   The analysis resulted in four themes, ethics are challenged in complex clinical situations, to create space for reflection, to see the human being, and to be touched by the patient. The results confirm that the encounter between health personnel and the patient is significant and that the encounter itself is immanent ethics. Health personnel work with a tension between a system characterized by busyness and chores and seeing the patient as a human being and being overwhelmed by his or her suffering. In this field of tension, health personnel can be in the movement of becoming and reflecting on what promotes and maintains ethical competence.I denne omsorgsvitenskaplige studien søker vi en dypere forståelse av helsepersonells erfaringer av utfordringer og grunnlag for å opprettholde etisk kompetanse i klinisk praksis. Studien har et kvalitativ design. Metodologien er hermeneutisk applikasjonsforskning. Tolv deltakere fra ulike profesjoner, fordelt på to grupper, deltok i dialoger om etisk kompetanse. Systematisk tekstkondensering er brukt som metode for å analysere dataene. Funnene presenteres i fire temaer: I komplekse kliniske erfaringer blir etikken utfordret, Å skape rom for refleksjon, Å se mennesket og Å bli berørt av pasienten. Resultatet bekrefter at møtet mellom helsepersonell og pasient er betydningsfullt, og at møtet i seg en iboende etikk. Helsepersonell arbeider i en spenning mellom å se mennesket i pasientrollen og å bli overveldet av lidelse i et system preget av travelhet og gjøremål. I dette spenningsfeltet kan helsepersonell være i en danningsprosess, gjennom refleksjon som fremmer og opprettholder etisk kompetanse. Funnene presenteres i fire temaer: I komplekse kliniske erfaringer blir etikken utfordret, Å skape rom for refleksjon, Å se mennesket og Å bli berørt av pasienten. Resultatet bekrefter at møtet mellom helsepersonell og pasient er betydningsfullt, og at møtet i seg en iboende etikk. Helsepersonell arbeider i en spenning mellom å se mennesket i pasientrollen og å bli overveldet av lidelse i et system preget av travelhet og gjøremål. I dette spenningsfeltet kan helsepersonell være i en danningsprosess, gjennom refleksjon som fremmer og opprettholder etisk kompetanse

Menneskets verdighet i kraft av det hellige rommet

The purpose of this thesis is to increase the understanding of and acquire knowledge about the nature of dignity in a caring science perspective. The study's starting point is the Caring Science research tradition developed by Eriksson and her research colleagues at Åbo Akademi University in Finland. The methodological approach is Gadamer’s (2007) ontological hermeneutics. The scientific interest has been directed at developing knowledge of the substance of dignity as a constituent of the core of caring science. The research therefore provides new substance to the axiom of dignity at Åbo Akademi University. The overarching research question is: What is the substance of dignity in light of Pico's Oratio, texts that interpret Oratio (Cassirer, 1942) (Kristeller, 1948) (Lindborg, 1974) (Nielsen, 2007), and empirical data from interviews with elderly women? The research questions linked to the empirical material are: What is dignity in light of aging and failing health? What is dignity for women when they look back on their lives? What do the women do to maintain their dignity? The research culminates in eight themes of dignity: love, holiness, greatness, freedom, human office, reconciliation, truth and beauty. These eight themes are sharpened and become four dignity themes: holiness, freedom, truth and beauty, where holiness symbolizes dignity’s innermost core. Man is created with dignity and is thus worthy throughout life. But in the particular life, the suffering human being can lose contact with his holiness and dignity. The more man extends towards the power source of dignity in the drama of suffering, the closer he gets to his own ontological core. The study’s findings help deepen the core of Caring Science theory

Dignity in fragile older women receiving daily municipality care

Background:Dignity is an important ideal in the nursing of older women who need municipal care. Dignity can be challenged when health is impaired by feeling grief and suffering associated with bodily changes and impaired functions. Aim and research questions:The study aimed to deepen the understanding of the meaning of dignity in the life of fragile older women who daily needed help from municipal care service. The research questions are: What is older women’s experience of dignity, and what is it not to be met with dignity when needing service from municipality care? Research design: The study has a qualitative design, and the methodology is based on Gadamer’s ontological hermeneutics. Ten women receiving municipal care, aged from 66 to 91 were interviewed in their home environments. Kvale and Brinkmanns’ three levels of interpretation were applied in the analysis of the interviews: self-understanding, a critical understanding based on common sense, and theoretical understanding. Ethical considerations: The study follows the guidelines for good scientific practice according to the Declaration of Helsinki and was approved by the Norwegian Centre for Research Data. Results: The interviews revealed fragments of the women’s unique life history. Two themes emerged from the interpretation: Confirming encounters provide human dignity; and Not being confirmed as a human being violates human dignity. Conclusions:For the women, dignity is about feeling seen and understood by the individual nurse and this takes place both in conversation and in bodily care. Not being seen or confirmed gives rise to suffering. The reason for this seems to be lack of competence on the part of the staff or little continuity

Spiritual care - an ethical basis for protecting patients dignity

Poster presentert på den internasjonale konferfansen “Spiritiual Care - The State of the Art and International Perspectives”, 18.oktober 2019 i Bergen

Spiritual care - an ethical basis for protecting patients dignity

Poster presentert på den internasjonale konferfansen “Spiritiual Care - The State of the Art and International Perspectives”, 18.oktober 2019 i Bergen

Nursing students’ experience with clinical placement in nursing homes: a focus group study

Background A renewed interest in nursing homes as clinical placement settings for nursing students has been prompted by the growing healthcare needs of an ageing population. However, if future nurses are to be enthusiastic about working in this healthcare context, it is essential that higher education institutions that educate nurses and nursing homes that provide placement experiences to students do so with a supportive, positive, and enriched approach. Methods To explore first-year nursing students’ placement experience in nursing homes, we conducted an exploratory qualitative study in three city-based nursing homes in western Norway. Thirteen first-year nursing students participated in the study. Three focus group interviews were conducted to explore the students’ placement experiences. Data were analysed using thematic analysis. The findings were reported using the Standards for Reporting Qualitative Research (SRQR). Results The analysis describes five themes relating to first-year students’ placement experience in nursing homes; (1) variations in utility of pre-placement orientation and welcome at placement site; (2) a challenging learning environment; (3) spending considerable placement time with non-registered nurses; (4) considerable variability in supervision practices; and (5) a vulnerable and demanding student role. Conclusions The research provides insight into the contextual characteristics encountered by first-year students that influence the quality of their placement experiences. Consequently, these characteristics impede access to important role models who lend support to a student’s growth and professional development, preventing full utilisation of the learning potential offered in nursing homes. Hence, we propose that targeted efforts are warranted to foster positive placement experiences and enhance students’ clinical education in nursing homes.publishedVersio

Leader as maintainer of multi-professional ethical competence in healthcare practice

Ethical competence is a core competence in healthcare, and healthcare leaders have a key position when it comes to maintaining professionals’ ethical competence. This study aims to broaden the understanding of leaders as maintainers of ethical competence in healthcare practice seen from a multi-professional perspective. The methodology for data collection was hermeneutic application research and hermeneutic dialogues in which participated 14 informants with different professional backgrounds at a university hospital and three researchers from a university in Norway. Thematic analysis was used as a data analysis method.The thematic analysis resulted in three themes: Creating a culture with common ethical values, Leading with clarity and supporting ethical acting, and Focusing on the patient and quality of life. The leader’s ethical character and passion to create care cultures based on common ethical values and actions, and where the focus is on the patient and quality of life maintain multiprofessional ethical competence