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The experience of being ill as narrated by hospitalized children aged 7-10 years with short-term illness

Children’s illness has been investigated through the eyes of parents and nurses but the child’s own perspective has been largely ignored. The aim of this study is to illuminate the 7-10-year-olds’ experiences of being ill. Three girls and four boys were interviewed and narrated their experience about short-term illness. The data obtained was subjected to a thematic qualitative content analysis. The analysis suggests that the children combined reality and imagination and contrasts seemed to coexist such as being scared/confident, sad/cosy and hurt/having fun. They felt caught and tried to escape. The experience of illness as narrated by children can lead to a richer understanding and influence the way we care for paediatric patients.

Ethical challenges in surgery as narrated by practicing surgeons

BackgroundThe aim of this study was to explore the ethical challenges in surgery from the surgeons point of view and their experience of being in ethically difficult situations.MethodsFive male and five female surgeons at a university hospital in Norway were interviewed as part of a comprehensive investigation into the narratives of nurses and physicians about being in such situations. The transcribed interview texts were subjected to a phenomenological-hermeneutic interpretation.ResultsNo differences in ethical reasoning between male and female surgeons were found. They reasoned in both action and relational ethical perspectives. Surgeons focused on their relationships with patients and colleagues and their moral self in descriptions of the ethical challenges in their work. Dialogue and personal involvement were important in their relationships with patients. The surgeons emphasized the importance of open dialogue, professional recognition, and an inclusive and accepting environment between colleagues.ConclusionThe surgeons are personally challenged by the existential realities of human life in their relationships with patients. They realized that ethical challenges are an inherent part of performing surgery and of life itself, and say that they have to learn to live with these challenges in a way that is confirmed both socially and by their inner moral self. This means accepting their personal and professional limitations, being uncertain, being fallible, and being humble. Living with the ethical challenges of surgery seems to contribute to the surgeons confidence and vulnerability in their professional identity.

The meaning of being in ethically difficult care situations in pediatrics as narrated by male registered nurses

The meaning of being in ethically difficult care situations in pediatrics as narrated by male registered nurses

Embodied suffering: experiences of fear in adolescent girls with cancer:

Previously, fear in adolescents with cancer has been sparsely described from an emic perspective. The aim of this study was to illuminate fear in adolescents with personal experience of cancer. The participants were six adolescent girls between the age of 14 and 16 years who were no longer under active treatment for cancer but still went for regular check-ups. Open interviews were conducted. Data were analysed according to the phenomenological hermeneutic method. In the result one main theme was identified: `an embodied fear — a threat to the personal self. This theme was built up by three separate but intertwined themes: `experiencing fear related to the physical body, `experiencing existential fear and `experiencing fear related to the social self. In the comprehensive understanding the fear was interpreted from youth cultural aspects as well as a holistic perspective. The importance of professionals taking the whole person and their situation into account when meeting the fear is underlined.

Action ethical dilemmas in surgery: an interview study of practicing surgeons

BackgroundThe aim of this study was to describe the kinds of ethical dilemmas surgeons face during practice.MethodsFive male and five female surgeons at a University hospital in Norway were interviewed as part of a comprehensive investigation into the narratives of physicians and nurses about ethically difficult situations in surgical units. The transcribed interview texts were subjected to a phenomenological-hermeneutic interpretation.ResultsNo gender differences were found in the kinds of ethical dilemmas identified among male and female surgeons. The main finding was that surgeons experienced ethical dilemmas in deciding the right treatment in different situations. The dilemmas included starting or withholding treatment, continuing or withdrawing treatment, overtreatment, respecting the patients and meeting patients expectations. The main focus in the narratives was on ethical dilemmas concerning the patients well-being, treatment and care. The surgeons narrated about whether they should act according to their own convictions or according to the opinions of principal colleagues or colleagues from other departments. Handling incompetent colleagues was also seen as an ethical dilemma. Prioritization of limited resources and following social laws and regulations represented ethical dilemmas when they contradicted what the surgeons considered was in the patients best interests.ConclusionThe surgeons seemed confident in their professional role although the many ethical dilemmas they experienced in trying to meet the expectations of patients, colleagues and society also made them professionally and personally vulnerable.

An expression of love – midwives’ experiences in the encounter with lesbian women and their partners

AIMnThis paper is a report of a descriptive study of midwives lived experiences of caring for lesbian women and their partners.nnnBACKGROUNDnA growing body of qualitative studies describes lesbian womens experiences of maternity care. Studies about midwives caring experiences in the encounter are needed to improve care for lesbian women and their partners.nnnMETHODnA qualitative study, using a phenomenological-hermeneutical method influenced by Ricoeur was conducted. Eleven midwives were recruited by snowball method. Interviews were conducted in 2009 and participants were encouraged to share events in their midwifery practice encountering lesbian women.nnnFINDINGSnThe midwives described the lesbian love-relationship as strong and caring, but including elements of difference which could make the couple vulnerable. It was important for midwives to acknowledge their own attitudes and culturally sensitive non-verbal communication; also to consider the co-mothers needs and role as different compared with those of fathers. Although caring for lesbian couples was seen as unproblematic, midwives described experiences of ambivalence or anxiety in the encounter and they had noticed that some couples had had negative experiences with maternity care.nnnCONCLUSIONnStudies are required to map content, consequences and coping strategies regarding the ambivalent or uncertain caring situations and to assess a co-mothers particular role and needs during pregnancy, labour and the postnatal period to provide tailored care for lesbian couples.

Ethical challenges related to elder care. High level decision-makers' experiences

BackgroundFew empirical studies have been found that explore ethical challenges among persons in high public positions that are responsible for elder care. The aim of this paper was to illuminate the meaning of being in ethically difficult situations related to elder care as experienced by high level decision-makers.MethodsA phenomenological-hermeneutic method was used to analyse the eighteen interviews conducted with political and civil servant high level decision-makers at the municipality and county council level from two counties in Sweden. The participants worked at a planning and control as well as executive level and had both budget and quality of elder care responsibilities.ResultsBoth ethical dilemmas and the meaning of being in ethically difficult situations related to elder care were revealed. No differences were seen between the politicians and the civil servants. The ethical dilemmas mostly concerned dealings with extensive care needs and working with a limited budget. The dilemmas were associated with a lack of good care and a lack of agreement concerning care such as vulnerable patients in inappropriate care settings, weaknesses in medical support, dissimilar focuses between the caring systems, justness in the distribution of care and deficient information. Being in ethically difficult situations was challenging. Associated with them were experiences of being exposed, having to be strategic and living with feelings such as aloneness and loneliness, uncertainty, lack of confirmation, the risk of being threatened or becoming a scapegoat and difficult decision avoidance.ConclusionOur paper provides further insight into the ethical dilemmas and ethical challenges met by high level decision-makers, which is important since the overall responsibility for elder care that is also ethically defensible rests with them. They have power and their decisions affect many stakeholders in elder care. Our results can be used to stimulate discussions between high level decision-makers and health care professionals concerning ways of dealing with ethical issues and the necessity of structures that facilitate dealing with them. Even if the high level decision-makers have learned to live with the ethical challenges that confronted them, it was obvious that they were not free from feelings of uncertainty, frustration and loneliness. Vulnerability was revealed regarding themselves and others. Their feelings of failure indicated that they felt something was at stake for the older adults in elder care and for themselves as well, in that there was the risk that important needs would go unmet.

Patients with acute chest pain : experiences of emergency calls and pre-hospital care

Acute chest pain is a common reason why people call an emergency medical dispatch (EMD) centre. We examined how patients with acute chest pain experience the emergency call and their pre-hospital care. A qualitative design was used with a phenomenological-hermeneutic approach. Thirteen patients were interviewed, three women and 10 men. The patients were grateful that their lives had been saved and in general were satisfied with their pre-hospital contact. Sometimes they felt that it took too long for the emergency operators to answer and to understand the urgency. They were in a life-threatening situation and their feeling of vulnerability and dependency was great. Time seemed to stand still while they were waiting for help during their traumatic experience. The situation was fraught with pain, fear and an experience of loneliness. A sense of individualized care is important to strengthen trust and confidence between the patient and the pre-hospital personnel. Patients were aware of what number to call to reach the EMD centre, but were uncertain about when to call. More lives can be saved if people do not hesitate to call for help.

Parental Handling of Fear in Children With Cancer; Caring in the Best Interests of the Child

The aim of this study was to gain a deeper understanding of how parents of children with cancer handle the fear in their children. Fifteen parents of 11 children participated in focus-group interviews. Data were analyzed by a phenomenological hermeneutical method. The results suggest that the parents handling was equivalent with caring in the best interests of the child. This included striving for the security and well-being of the child up to a certain point where the parents instead used their authority to maintain the childs physical health rather than trying to prevent or relieve the childs fear.

Responsible but unprepared: Experiences of newly educated nurses in hospital care

The purpose of this study was to highlight the experience of being newly educated nurses working in internal medicine and surgical units. The nurses were asked to recount their initial work experiences using a narrative approach. A phenomenological hermeneutic method developed for life experience research was applied in the analyses. The study participants were surprised by the discrepancy between the ideals and the theoretical and practical knowledge gained during their nursing education, and the assigned hospital tasks designated as routine care. Prominent features of this were a focus on medical diagnostics and treatment, task orientation and efficiency. Holistic nursing was not felt to be a priority within the unit. This led to frustration and feelings of inadequacy and unpreparedness. They also felt that the responsibility was overwhelming. The findings described are discussed in the context of related publications.