Unni Å. Lindström

The meaning of reconciliation : Women’s stories about theirexperience of reconciliation with suffering from grief

INTRODUCTION Grief can be seen as a form of suffering. In this study grief was not only defined as loss, but as the process of inner suffering caused of some kinds of loss. We must recognise the importance of increased understanding for patient reconciliation with grief to expand earlier formulated knowledge about health and suffering. The aim of this study was to illuminate the meaning of reconciliation among women suffering from grief. METHODS A qualitative explorative design with a hermeneutic narrative approach was used to analyse and interpret the interviews. Caring theory about health, suffering and hermeneutical philosophy about understanding provided the point of departure for the analysis. The study was approved by an ethical research committee. RESULTS Findings reveal different plots that give light to the meaning of reconciliation in the different phases of analysis. In the womens narratives the meaning of reconciliation is a process to a new way of seeing, but also to opening and transition from the experience of grief and suffering to the experience of health and wholeness. CONCLUSIONS Reconciliation has a progressive form and the meaning of reconciliation cannot be seen as synonymous or homogenous but an understanding of reconciliation as a heterogenic synthesis of health and suffering. Understanding the reconciliation process will enable nurses to plan and provide professional care, based on caring science.

Listening to the Otherness of the Other: Envisioning Listening Based on a Hermeneutical Reading of Lévinas

The aim of this article is to elucidate the essence of listening through a hermeneutical reading of the works of philosopher Emmanuel Lévinas. This research is grounded in the human scientific caring tradition that is founded on an ethical order and explicitly theoretical framework. Listening as an ethical bearing is interpreted as a desire to follow the inner essential decision to take human responsibility seriously, to put oneself at risk, and as a promise to serve the vulnerable and unique Other in his or her otherness. Listening invites the individual to see and to respond to the Others address and thereby to welcome the holy and the infinite in a world where all human beings are tied together into a common humanity.

Clinical caring science as a scientific discipline

BACKGROUND Clinical caring science will be described from a theory of science perspective. AIM The aim of this theoretical article to give a comprehensive overview of clinical caring science as a human science-based discipline grounded in a theory of science argumentation. FINDINGS Clinical caring science seeks idiographic or specific variations of the ontology, concepts and theories, formulated by caring science. The rationale is the insight that the research questions do not change when they are addressed in different contexts. The academic subject contains a concept order with ethos concepts, core and basic concepts and practice concepts that unites systematic caring science with clinical caring science. In accordance with a hermeneutic tradition, the idea of the caring act is based on the degree to which the theory base is hermeneutically appropriated by the caregiver. The better the ethos, essential concepts and theories are understood, the better the caring act can be understood. In order to understand the concept order related to clinical caring science, an example is given from an ongoing project in a disaster context. COMPREHENSIVE REFLECTION The concept order is an appropriate way of making sense of the essence of clinical caring science. The idea of the concept order is that concepts on all levels need to be united with each other. A research project in clinical caring science can start anywhere on the concept order, either in ethos, core concepts, basic concepts, practice concepts or in concrete clinical phenomena, as long as no parts are locked out of the concept order as an entity. If, for example, research on patient participation as a phenomenon is not related to core and basic concepts, there is a risqué that the research becomes meaningless.

Hermeneutic caring conversations in forensic psychiatric caring

Background: In forensic psychiatric care, a hermeneutic caring conversation between caregivers and patients can improve health outcomes. The hermeneutic approach entails starting from the whole and involves openness for what is shown as well as paying attention to the different parts. One way to deepen these conversations is to take advantage of both the caregivers’ and the patients’ life experiences. Research questions: The purpose of the study is to discuss and reflect on what hermeneutic caring conversations can mean for a deepened understanding of the movement in the health processes of patients in forensic care, patients who are in deep suffering. Research design: This study uses a hermeneutic methodology. Conversations with patients receiving care in forensic psychiatry are deepened using texts from philosophy, caring science, and poetry. The outcome emerges through a phase of creating patterns. Participants: Three patients in forensic care. Ethical considerations: This study builds on a doctoral thesis approved by The Ethical Review Board at the Faculty of Medical and Health Sciences, Linköping, Sweden. Findings: Hermeneutic caring conversations provide a possibility for rich caring conversations with patients who are often not given a voice. These conversations are seen as ethical expressions of hermeneutic caring communion that affect patients’ health processes in a positive way. Discussion: It takes courage and responsibility to initiate and conduct these conversations as the patients volunteer to share their suffering. In hermeneutic caring conversations, the caregiver’s attitude is crucial for the transference of knowledge. Conclusion: This study provides a preliminary outline for hermeneutic caring conversations. A caring culture that provides time and space to prepare hermeneutic caring conversations is a prerequisite for the implementation of hermeneutic caring conversations.

Longing – A Dynamic Power in the Becoming of Health

The study describes a preliminary theoretical model for understanding the substance of longing, based on interpretation of texts from Augustine and Kierkegaard. The model demonstrates how the dynamic power inherent in longing can be utilized to create health processes. Processes of change unfold through suffering and love, which start an inner dialogue that leads to a form of transparency. Vulnerability makes the process of longing challenging, but the longing has a connectedness to the source of love that renders human beings more transparent. The process of longing can create change and metamorphosis, similar to an ontological homecoming, expressed as gratitude and more definite longing.

Assessing Trustworthiness in Hermeneutical Studies – A Discussion

Trustworthiness in hermeneutical studies is the subject we employ in this article. The discussion has focus on trustworthiness and data collected through conversations, the different participants’ contribution in conversations, and the importance of having the subject matter in focus in the conversations. Gadamer’s hermeneutical philosophy of fusions of horizon, his emphasis on the subject matter, and the research goal of generating knowledge on the level of universality are topics to be examined. We discuss, through examples, one way of pointing at universal knowledge or ontological evidence in research

Longing – a dynamic power in the becoming of health when suffering from cancer

BACKGROUND The aim of the study was to gain understanding of existential longing in health and suffering as experienced by persons who have been affected by a cancer disease. The theoretical perspective of the study is K. Erikssons theory of Caring Science. METHOD Qualitative interviews with nine women with cancer were transcribed and interpreted using Gadamers ontological hermeneutics. RESULTS Four perspectives of longing when suffering from cancer are presented: Longing as a source to call upon for survival, Longing for the life prior to the illness, Longing directed towards deeper relations in everyday life, and Transcending longing moves towards the ultimate fulfilment. INTERPRETATION The overall interpretation led to the following thesis about the dimension of longing in the human being: Longing is becoming in a movement towards reconciliation of life, and, Longing is becoming in a movement towards transcending life. CONCLUSION The results show that there seems to be a dynamic power in longing that can transform suffering and create health.

Toward Understanding Through Hermeneutic Letterwriting

The authors present letterwriting as a hermeneutic research method in that it contributes to the methodological development within the hermeneutical research tradition in caring science. The hermeneutic methodology is inspired by Hans-Georg Gadamer. Hermeneutic letterwriting in accordance with Gadamer’s thought is a form of dialogue in writing, where what is truthful about the thing itself is unveiled with the help of the language. Hermeneutic letterwriting is presented in five steps. As a method, hermeneutic letterwriting is appropriate for complex caring science issues, and it offers new opportunities for attaining a deeper understanding of the world of caring.

Rediscovering Claritas as the Illuminator of the Great Order of Truth, Good, and Beauty Within Caring Science

The aim of this article is to illuminate and explore the universal meaning of claritas. In caring science and caritative caring, the unity of truth, good, and beauty constitutes the fundamentals, but the unity does not become ontologically evident before claritas enters the arena. Claritas guides human performance, and it is the clear light which brings about caritas. Thus, claritas might facilitate carrying out what is good in a responsible, courageous, and Âretian way, meaning that all caring is grounded in ethos and wisdom. “To the same extent as caritas, claritas should be considered a core concept in caring science.”