Phenomenology and hermeneutics as a basis for sensitivity within health care.

An educated healthcare professional or student is sensitive and able to make good judgements, understanding existential challenging issues. It is argued that the ideas within phenomenology and hermeneutics can function as a basis for comprehension. This article focuses on how choice of perspective and knowledge is of importance to what we do in practice. However, education does not consist of mere accumulation of knowledge and ways of explanation. We do not become competent practitioners by being able to reproduce philosophical ideas. These are merely perspectives by means of which we can seek to go beyond what we take for granted, or what we assume to know, thus enabling us to take a new direction understanding problems and issues that until now may have been hidden to us. In other words, understanding is of an existential character, whereas an observing healthcare professional must be aware and open to the mental aspects of life. It is therefore important to attune ourselves to being sensitive to and aware of experiences from our lifeworld, understanding what they imply. It is argued that literature provides insight into human nature through the written depiction of real or imagined experiences. To develop such narrative imagination, it is suggested that literature should be part of the curriculum of various educations. This is relevant to healthcare professionals who thereby can get an important insight into human nature and begin to develop the self-awareness and sensitivity to others that is so central to care.

Live music in the intensive care unit - a beautiful experience.

BACKGROUND: The growing number of lightly or non-sedated patients who are critically ill means that more patients experience the noisy and stressful environment. Live music may create positive and meaningful moments. PURPOSE: To explore non-sedated patients' experiences of patient-tailored live music interventions in the intensive care unit. DESIGN: A qualitative study using a phenomenological-hermeneutic approach. Data were collected at two intensive care units from September 2019 to February 2020 exploring 18 live music interventions performed by music students from The Royal Academy of Music, Aarhus, Denmark. METHODS: Observations of live music interventions followed by patient interviews. All data together were analysed using Ricoeur's theory of interpretation. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was used. RESULTS: Five themes emerged: 1) A break from everyday life, 2) A room with beautiful sounds and emotions, 3) Too tired to participate, 4) Knowing the music makes it meaningful and 5) A calm and beautiful moment. CONCLUSION: Patient-tailored live music to awake patients is both feasible and acceptable and perceived as a break from every-day life in the ICU. IMPLICATIONS FOR PRACTICE: Supporting health and well-being by bringing a humanizing resource into the intensive care setting for patients and nurses to enjoy.

The experiences of patients with amyotrophic lateral sclerosis of their decision-making processes to invasive home mechanical ventilation-A qualitative study.

AIM: To explore and gain knowledge of the experiences and needs among patients with amyotrophic lateral sclerosis (ALS) of their decision-making processes whether to choose invasive home mechanical ventilation or not. DESIGN: A qualitative study. METHODS: A phenomenological-hermeneutic approach influenced by Ricoeur's interpretation theory was used. Seven patients with ALS were interviewed. The Consolidated Criteria for Reporting Qualitative Research checklist was used for reporting. RESULTS: Three themes were evident in patients' accounts of the decision-making process: (1) being taken care of directly after receiving the diagnosis, (2) living in uncertainty about what the future would bring and (3) doubt causing patients with ALS to change their minds. Patients with ALS were burdened with everyday life challenging decision-making processes about future treatment and doubt caused patients to change their minds about their future treatment. It is necessary to support patients in their decision-making processes using shared decision-making. PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution.