Maintaining power: women's experiences from labour onset before admittance to maternity ward.

BACKGROUND: In Sweden pregnant women are encouraged to remain at home until the active phase of labour. Recommendation is based on evidence, that women who seek care and are admitted in the latent phase of labour are subjected to more obstetric interventions and suffer more complications than women who remain at home until the active phase of labour. The aim of this study was to obtain a deeper understanding of how women, who remain at home until the active phase of labour, experience the period from labour onset until admission to labour ward. METHOD: Interviews were conducted with 19 women after they had given birth to their first child. A Constructivist Grounded theory method was used. FINDINGS: 'Maintaining power' was identified as the core category, explaining the women's experience of having enough power, when the labour started. Four related categories: 'to share the experience with another', 'to listen to the rhythm of the body', 'to distract oneself' and 'to be encased in a glass vessel', explained how the women coped and thereby maintained power. CONCLUSIONS: The first time mothers in this study, who managed to stay at home during the latent phase of labour, had a sense of power that was expressed as a driving force towards the birth, a bodily and mental strength and the right to decide over their own bodies. This implies that women who maintain power have the ability to make choices during the birth process. The professionals need to be sensitive, supportive and respectful to women's own preferences in the health-care encounter, to promote the existing power throughout the birthing process.

Accepting and adjusting: older women's experiences of living with urinary incontinence.

PURPOSE: The aim of this study was to describe experiences of living with urinary incontinence (UI) among persons who do not desire further assessment and treatment. METHODS: This was a qualitative, descriptive interview study, and the method was phenomenological. Eleven women were interviewed; all had been in contact with a district nurse to obtain a prescription for sanitary protection. None of the women desired further treatment for UI. FINDINGS: The women described living with UI as a manageable problem with which they had learned to live. They showed strength and desire to manage on their own. In many cases, other health problems overshadowed leakage problems. Several women saw health care services as a barrier that needed to be overcome before help could be obtained. Three key constituents emerged in the analysis: "learning to live with it despite difficulties," "other illnesses are more important," and "reluctance to seek care." For these women, the essence of the phenomenon of living with urinary incontinence (UI) can described as "a situation to accept and adjust to."

Closeness and distance: a way of handling difficult situations in daily care.

AIMS AND OBJECTIVES: The aim of this study was to describe how care team members caring for patients with advanced cancer describe how they handle difficult situations in daily care. In this paper 'difficult situations' refers to those situations team members themselves describe as difficult. BACKGROUND: Serious illness and impending death involve great changes in a person's life. The care of patients with advanced cancer is complex and many different factors influence each care situation. This places demands on the way care team members handle problems and difficulties in daily care. DESIGN: Qualitative descriptive study. METHODS: The study is based on 16 focus group discussions with care team members who were caring for patients with advanced cancer at three different care units in two Swedish cities. The focus group discussions included 77 participants. The procedure for data analysis was inspired by the phenomenological method. FINDINGS: The results show that care team members handled difficult situations by balancing between being close and distancing themselves. In most situations their choice of strategy seemed spontaneous rather than being a conscious decision, although it was sometimes described as a more conscious approach. Variations of closeness and distance that were identified were Identity, Meaning, Limit-setting and touching, Prioritization, the Team and the Organization. These could also be seen as tools that could facilitate or impede the use of closeness and distance. CONCLUSIONS: The results show that care team members have a need to reflect over daily care and to become aware of what governs different care actions. RELEVANCE TO CLINICAL PRACTICE: If the experienced difficult situation is not handled in a way that is beneficial to the care team member, patient and relatives, it is assumed that this can result in stress, burnout and, above all, non-optimal care.