Iréne von Post

Concept determination of Human dignity

This study presents findings from an ontological and contextual determination of the concept of dignity. The study had a caritative and caring science perspective and a hermeneutical design. The aim of this study was to increase caring science knowledge of dignity and to gain a determination of dignity as a concept. Eriksson’s model for conceptual determination is made up of five part-studies. The ontological and contextual determination indicates that dignity can be understood as absolute dignity, the spiritual dimension characterized by responsibility, freedom, duty, and service, and relative dignity, characterized by the bodily, external aesthetic dimension and the psychical, inner ethical dimension. Dignity exists in human beings both as absolute and relative dignity.

Continuity created by nurses in the perioperative dialogue – a literature review

This literature review analyses eight research reports dealing with perioperative dialogues conducted between patients and nurses. The aim of this study was to summarise studies concerned with the perioperative dialogue as an organisation model for bringing safe operative practices and caring into perioperative nursing, by creating continuity for both patients and nurses in perioperative praxis and its research. How do patients and perioperative nurses experience the perioperative dialogue as a model? Perioperative nursing should be perceived as a caring profession emphasising that the focus is on perioperative caring. The perioperative dialogue has a humanistic and caring perspective and presents an ideal model on which to base perioperative nursing. There is general acceptance of the value of the perioperative dialogue for both patients and nurses as means of alleviating suffering and creating a safety nursing, with continuity in the process provided by nursing staff. This study suggests further research and that a means of measuring caring in the perioperative dialogue should be more developed.

The development of caring in the perioperative culture : Nurse leaders' perspective on the struggle to retain sight of the patient

This article focuses on Swedish nurse leaders and is aimed at achieving a more complete and differentiated understanding of what constitutes caring in the perioperative culture as well as their knowledge and responsibility for the development of caring. Interviews with open-ended questions were conducted with 10 nurse leaders, in which they described their experiences of developing perioperative caring. The interpretation process was based on Gadamers philosophy of hermeneutics. The findings indicate that developing a perioperative caring culture is a struggle to retain sight of the patient, a process that includes the following 6 phases: (1) when the nurse leaders understood perioperative caring as a process, the nurses and patients shared world became obvious to them; (2) safeguarding the patients position as a unique human being; (3) safeguarding the nurses welfare by creating a compassionate atmosphere; (4) promoting an idea means never giving up; (5) attaching importance to being trustworthy; and (6) being involved in a dynamic interaction, comprising communion and reciprocity. The most important goal of nursing leadership is to safeguard the welfare of the suffering patient and the relationship between the nurse leader and nursing staff, based on the motive of caritas derived from the idea of humanistic caring.

The ideal and practice concepts of Ôprofessional nursing care

The purpose of this article is to make a determination of the concept ‘professional nursing care’ and to demonstrate its specific features. Through an ontological and contextual determination, caritas emerges as the basic motive, as a prerequisite for ‘professional nursing care’, with its characteristics human love, charity, courage, and human being. Human dignity comes out as the ethos of caritas and as the ethos of professional nursing care, as the ethical basic view. If we exclude ‘human dignity’ from professional nursing care, professional nursing care ceases to be professional.

Preserved and violated dignity in surgical practice – nurses’ experiences

The aim of this article was to obtain an understanding of what is experienced as human dignity by nurses in surgical practice. In order to obtain experiences from practice, the critical incident technique was chosen. A total of 11 nurses from surgical practice wrote 49 stories about positive and negative incidents. The text was analysed using hermeneutical text interpretation. The findings revealed patient dignity in terms of preserved dignity, that is, healthcare professionals paid attention to the patient. Nurses experienced preserved dignity when healthcare professionals allowed the patient to tell their story, allowed themselves to get close to the patient and in turn received the patient’s trust. Violated dignity included circumstances when the nurses were forced to see what they did not want to see. Nurses experienced violated dignity when healthcare professionals behaved rudely towards the patient, acted as if he or she was invisible or humiliated the patient at the end of life.

The experiences of parents of children with severe autism in connection with their children’s anaesthetics, in the presence and absence of the perioperative dialogue: a hermeneutic study

The aim of this study was to obtain an understanding of what parents of children with severe autism experience in connection with their childs anaesthetics, in the presence and absence of the perioperative dialogue. Twelve parents who had experience of their child receiving anaesthetics on one or more occasions took part in this study, in which anaesthesia care was organized as a perioperative dialogue. Data were collected by means of conversational interviews, and the text was interpreted using a hermeneutic approach. The hermeneutic text interpretation led to a new understanding based on the knowledge that in the absence of the perioperative dialogue, previous anaesthetics had meant the suffering of care by the following: a hopeless struggle, unspeakable suffering and a disgraceful scenario. However, continuity in the perioperative dialogue provided to be a way out of the suffering by being received by warm hands, being received by a known face and a subtle interplay between the child and nurse. Although health and well-being may be unobtainable goals in this special context of care, the findings provided ample descriptions of the positive effects of the perioperative dialogue, which is all the more valuable when dealing with children who will need repeated anaesthetics in the future.

Hermeneutics and Human Interplay: A Clinical Caring Science Research Method

The aim of this article was to explore, exemplify, and discuss how a participatory hermeneutic method designed for children with special needs can be developed in a caring context. Examples from a clinical study are presented to illustrate how play, as both a methodological concept in hermeneutics and the substance of caring, was applied in research by means of the perioperative dialogue. In participatory research, an ethical approach based on subtle human interplay can be triggered by means of dialogue with parents. Thus, truth can emerge via continuity of care, while the substance of caring can be directed toward the child. Such a clinical method is worth adding to the child research repertoire.

Student nurses’ experiences of preserved dignity in perioperative practice – Part I

Background: In recent years, operating theatre nurse students’ education focussed on ethical value issues and how the patient’s dignity is respected in the perioperative practice. Health professionals are frequently confronted with ethical issues that can impact on patient’s care during surgery. Objective: The objective of this study was to present what operating theatre nurse students experienced and interpreted as preserved dignity in perioperative practice. Research design: The study has a descriptive design with a hermeneutic approach. Data were collected using Flanagan’s critical incident technique. Participants and research context: Operating theatre nurse students from Sweden and Norway participated and collected data in 2011, after education in ethics and dignity. Data consisting of 47 written stories and the text were analysed with hermeneutical text interpretation. Ethical considerations: The study was conducted accordance with the Declaration of Helsinki and approved by a local University Ethics Research Committee. Findings: The findings revealed that students experienced that operating theatre nurses perserved patients dignity in perioperative practice by being present for each other and making themselves known to the patient. Operating theatre nurses caring for the patient by being compassionate and preserved the patient privacy. The new understanding that emerged was that the operating theatre nurse students understood that the operating theatre nurse wanted to care for the patient like a human being. Discussion: In the discussion, we have illuminated how professional ethics may be threatened by more pragmatic and utilitarian arguments contained in regulations and transplant act. Conclusion: Preserved dignity is an ethical and caring act. Ethical questions and how to preserve dignity in perioperative practice should be discussed more both in educations of healthcare professionals and in clinical practice.

Older patients and the perioperative dialogue - a hermeneutical study

This study described who the older patient undergoing surgery is as part of the perioperative dialogue and in order to understand their needs. The study used a hermeneutical design. Data were 54 transcribed stories from perioperative dialogues. The findings show that older patients undergoing surgery were persons: (a) with memories of the life they had lived, (b) whose body had betrayed them, (c) who were worried and afraid before the operation, and (d) who will need help from family and friends. The older patient is a unique human being, a wholeness with a past of their own and a life they have lived: the present – a time of change and the future – a time for recovery.