Ingunn Elstad

The bodily experience of apraxia in everyday activities: a phenomenological study

Purpose: The aim of this study is to explore apraxia as a phenomenon in everyday activities, as experienced by a group of stroke patients. Some consequences for clinical practice are suggested. Method: In this phenomenological hermeneutical study, six persons with apraxia were followed from 2 to 6 months, from the early phase of stroke rehabilitation. ADL-situations and interactions with therapists were observed and videotaped repeatedly during the rehabilitation trajectory, to provide access to and familiarity with the participant’s apractic difficulties over time. Two in-depth interviews were conducted with each participant. Interviews and video observations were analyzed together, taking Merleau-Ponty’s concept of bodily intentionality as basis for analysis and his phenomenology as the main theoretical perspective of the study. Results: Five types of altered bodily intentionality were described by the participants [1]: Gap between intention and bodily action [2], Fragmented awareness in action [3], Peculiar actions and odd bodies [4], Intentionality on the loose, and [5] Fighting against tools. These were recognized as characteristics typical of the apraxia experience. Conclusion: The phenomenology of Merleau-Ponty, and his concept of bodily intentionality in particular, elucidate the way specific apractic difficulties come into being and may thus render apraxia less incomprehensible. The apraxia phenomenon appears as characteristic fragmentations of anticipation inherent in action performance, thereby “slackening” the bodily intentionality. Identifying apractic changes of intentionality may help health professionals to adjust and individualize therapy, and facilitate patients’ acting competence in everyday life. Implications for Rehabilitation Few studies have explored how apraxia appears in everyday life activities, e.g. during rehabilitation practice. The study explores apraxia as a phenomenon in everyday activities, as experienced by a group of stroke patients. Merleau-Ponty’s concept of bodily intentionality constitutes the analytic focus. Reflection upon changes of intentionality in illness may help professionals focus on patients’ experiences and their struggles. Findings support the necessity of the user perspective, with a more adapted, individualized and contextualized occupational therapy.

Continuity and Change in Life Engagement Among People With Dementia

The purpose of this study was to explore the change and continuity in the engagement in life of people with advanced dementia. The idea of meaningful activities is commonly used in nursing research, but few studies have been performed on what makes activities meaningful. This study aims to shed light on the meaning of activities in a life course context, changes in activity patterns due to dementia disease, and the significance of narratives told by close relatives. The 11 stories of activities were analyzed using thematic narrative analysis with Leontyev’s activity theory as a theoretical framework. The findings revealed several types of changes: slow and abrupt changes in everyday and physical activities, changes in the person’s level of awareness, and changes in habits in new care settings and environments. The meaningfulness of activities was connected to a person’s background, his/her motives, lifestyle and identity, and the contextuality of activities. Through the narratives, nursing care personnel could acquire a nuanced picture of the person and his/her engagement in life. These narratives are vital to helping people who have dementia to keep up with meaningful activities and enhance their quality of life, especially when the person has deficiencies in communication.

Understanding the Experiences of Hearing Voices and Sounds Others Do Not Hear

In this article, we aim to contribute to the understanding of how people with mental illness experience hearing voices and sounds that others do not hear in daily life. We conducted in-depth interviews with 14 people and analyzed the interviews using a hermeneutic phenomenological approach. The themes we arrived at included the following: hearing someone else or myself, am I losing my mind?, and daily life recurrently dominated by opposing voices. Our overall understanding of how the voices and sounds were experienced in daily life was that the intentions of others resounded intrusively in the participants and disrupted their lives. The tones and contents of these perplexing perceptions echoed and amplified past, present, and future experiences and concerns. The results elucidate the value that exploring and attempting to understand people’s daily life experiences of hearing voices and sounds might have for the voice hearer, his or her family, and health care providers.

Personer med demenssykdom i sykehjem: Refleksjon over livet

Abstract Persons with dementia disease in nursing homes: Reflection about life The article is based on interviews with eight individuals with dementia disease living in nursing homes in Northern Norway. They were asked to tell about their lives, especially habits, interests and activities through the lifespan. Narrative analysis was conducted, phases and happenings through the lifespan were especially important for the interpretation. The persons reflected about their lives, they held up what had been meaningful to them, what they wanted to continue in the nursing home, and how they experienced living with dementia disease. The article holds up the importance of letting the patient tell from his or her life to be able to experience sense of coherence when moving to the nursing home. Continuing contact with family, relationship with nature, animals, local food traditions, singing and music, were also told about as meaningful activities throughout lifespan and in the nursing home.

‘‘Sometimes I walk and walk, hoping to get some peace.’’ Dealing with hearing voices and sounds nobody else hears

Our objective in this article is to add to the understanding of how people with mental illness experience dealing with hearing troublesome voices and sounds in everyday life. Fourteen people contributed through in-depth interviews and we analysed these using a hermeneutic phenomenological approach. We found that the participants (a) tried to block out the voices and sounds, (b) navigated the health care services, and (c) struggled to come to terms with limitations. Our overall understanding of how the participants dealt with hearing voices is that they sought to be independent and lead ordinary lives despite being troubled by voices. The participants fought desperately to find relief and avoid being overcome by the voices and sounds in intense phases. In less intense phases, they developed ways of getting along with daily life in spite of these experiences. We reflect on the implications of these findings and emphasize the need for care providers to attempt to understand and engage in collaborative explorations with service users in search of the most helpful ways of dealing with hearing troublesome voices and sounds in everyday life.Our objective in this article is to add to the understanding of how people with mental illness experience dealing with hearing troublesome voices and sounds in everyday life. Fourteen people contributed through in-depth interviews and we analysed these using a hermeneutic phenomenological approach. We found that the participants (a) tried to block out the voices and sounds, (b) navigated the health care services, and (c) struggled to come to terms with limitations. Our overall understanding of how the participants dealt with hearing voices is that they sought to be independent and lead ordinary lives despite being troubled by voices. The participants fought desperately to find relief and avoid being overcome by the voices and sounds in intense phases. In less intense phases, they developed ways of getting along with daily life in spite of these experiences. We reflect on the implications of these findings and emphasize the need for care providers to attempt to understand and engage in collaborative explorations with service users in search of the most helpful ways of dealing with hearing troublesome voices and sounds in everyday life.Our objective in this article is to add to the understanding of how people with mental illness experience dealing with hearing troublesome voices and sounds in everyday life. Fourteen people contributed through in-depth interviews and we analysed these using a hermeneutic phenomenological approach. We found that the participants (a) tried to block out the voices and sounds, (b) navigated the health care services, and (c) struggled to come to terms with limitations. Our overall understanding of how the participants dealt with hearing voices is that they sought to be independent and lead ordinary lives despite being troubled by voices. The participants fought desperately to find relief and avoid being overcome by the voices and sounds in intense phases. In less intense phases, they developed ways of getting along with daily life in spite of these experiences. We reflect on the implications of these findings and emphasize the need for care providers to attempt to understand and engage in collaborative explorations with service users in search of the most helpful ways of dealing with hearing troublesome voices and sounds in everyday life.

Smitte, språk og kultur. Tuberkulosearbeidet i Finnmark

Smitte, sprak og kultur. Tuberkulosearbeidet i Finnmark. [Contagion, language and culture. Tuberculosis work in Finnmar]. Teemu Ryymin: Oslo, Scandinavian Academic Press/Spartacus Forlag, 2009, 368...

Life Support in High Age: Northern Norway 1865-1900

This article explores how very old people in Northern Norway supported life before economic modernization, from nineteenth-century census registrations and ethnographic sources. Very few lived alone. About 80 percent were primarily supported by living with relations—family, kin, or nonkin, participating with work and experience, the majority through a retirement agreement. In the northernmost parts, where Sámi traditions of land ownership dominated, retirement was uncommon. Other very old supported life from independent work or public relief. Old women with few ties were at particular risk of destitution.

Familie og kontinuitet: Pårørende forteller om livsløpet til personer med demenssykdom

Artikkelen bygger pa intervju av naere parorende om livslopet til pasienter med demenssykdom som bor i sykehjem i Nord-Norge. De parorende ble spesielt spurt om pasientenes vaner, interesser og aktiviteter gjennom livslopet. Det ble utfort narrativ analyse av intervjuene med vekt pa fortolkning av livslop og livshendelser hos pasientene. Artikkelen viser hvordan parorende konkret bidrar til a viderefore kontinuiteten i livslopet til pasienten, samtidig som det kommer fram hvordan denne kontinuiteten ogsa har stor betydning for parorende i deres eget liv. Artikkelen viser og at for at pasienten skal oppleve kontinuitet i eget liv etter flytting til sykehjem, er det viktig med en form for kontakt med hjemplass og landskap, og at det gis rom for tradisjoner og livshistorie .

Infant mortality and epidemic diseases. Wartime Finnmark in a comparative perspective

The effects of war on the health of the population have never been systematically studied. The article explores the impact of war on the general health condition of Finnmark’s population during the war years. The indicators chosen are infant mortality and the epidemic diseases diphtheria, scabies and acute gastroenteritis. The development of the indicators in Finnmark is compared with the averages in Norway and Finnish Lapland. The findings deserve attention. The article discusses the statistical indicators and findings in a social and historical context with a range of sources. The article is a broad as well as penetrating analysis of the war’s impact on the health of the civilian population of Finnmark and on their everyday living and survival.