Being met as a person and not as a diagnosis - Meanings of healthcare encounters for women with chronic obstructive pulmonary disease stage III or IV.

Our study seeks to elucidate meanings of healthcare encounters for women with chronic obstructive pulmonary disease stage III or IV. We conducted 12 narrative interviews which were analyzed using phenomenological hermeneutic interpretation. Our analysis revealed one theme; being met as a person and not as a diagnosis with three subthemes: getting sufficient time and feeling involved in care; fulfillment of personal needs; and experiencing disrespect and injustice. We found that meanings of healthcare encounters center on the expectation of being seen as a person. Feeling disrespected and injust leaves women unsupported and could pose serious health risks.

The Experiences of Close Relatives to Women with Chronic Obstructive Pulmonary Disease Stages III or IV: A Qualitative Study.

Chronic obstructive pulmonary disease stage III or IV is a progressive and incurable disease. The hallmark of the disease is breathlessness, and it is graded into four different stages, from mild to severe. Living with chronic obstructive pulmonary disease impacts almost every aspect of everyday life for an affected person. As the illness progresses to stages III and IV, the need for support from close relatives increases. The aim of this study was to explore and describe the experiences of close relatives of women with chronic obstructive pulmonary disease stage III or IV and it used qualitative content analysis of individual, semi-structured interviews. Close relatives (n = 9) were interviewed about their experience of being close to a woman with chronic obstructive pulmonary disease stage III or IV. They experienced stress and uncertainty in an unpredictable everyday life. Close relatives supported the women both practically and emotionally and they called for tailored information about the illness, considering it as an essential tool for support. The results highlighted that healthy close relatives had difficulty in understanding the experience of living with chronic obstructive pulmonary, as they take the simple fact of breathing for granted most of the time.

Striving for moments of easier breathing despite being trapped in breathlessness: meanings of feeling well for women with chronic obstructive pulmonary disease stage III or IV.

BACKGROUND: Living with chronic obstructive pulmonary disease stage III or IV means living an everyday life, severely restricted by breathlessness. AIM: The aim of this study was to elucidate meanings of feeling well for women with chronic obstructive pulmonary disease stage III or IV. METHOD: The study has used a phenomenological hermeneutical design. Individual narrative interviews were conducted with 14 women with chronic obstructive pulmonary disease at stages III or IV. RESULTS: The results revealed one theme: striving for moments of easier breathing despite being trapped in breathlessness with four subthemes: acting in rhythm with breathing, taking care of oneself, taking advantage of better moments, and being in togetherness in everyday life. CONCLUSION: This study shows that women with chronic obstructive pulmonary disease at stages III or IV strived for moments of feeling well despite living with a severe illness. Feeling well meant that when connected to nature, they felt alive, free, and less trapped in breathlessness, which provided a sense of being unconscious of their breathing rhythm. They could do what healthy people tend to take for granted during everyday life. To feel well, the women found it important to receive tailored support from their close relatives.

Experiences of transitions in daily life for parents of children with type 1 diabetes: An interpretive description.

In this study, we aimed to explore and describe the experiences of parents whose children have been diagnosed with type 1 diabetes (T1D) and the transitions of daily life. T1D is a long-term illness, and parents of children with T1D often become informal caregivers and face many challenges in their daily lives. A qualitative study design, in line with interpretive description, was used, and a sample of 10 parents of children with T1D participated in individual interviews. The COnsolidated criteria for REporting Qualitative Research (COREQ) checklist was used. The interviews were analyzed using interpretive descriptions. The analysis resulted in one main theme: "The realization of having taken 'daily life' for granted and having to accept a new reality," with six themes showing different transitions in the parents' daily lives, including transitions in daily life patterns, parenthood, in relationships with family and friends, relationships with school personnel, relationships with healthcare personnel, and in knowledge and learning about the illness. Parents experienced multifaceted changes that affected their lives, as shown by the six identified transitions. Being the parent of a child with T1D implies a new reality with complex, irreversible life changes that may be unknown and unspoken to healthcare professionals and society. Healthcare systems, school personnel, and society at large need to improve their knowledge regarding parents' situations to better support them in embracing a new reality for themselves and their children long after the onset of T1D.

Dignity encounters: the experiences of people with long-term illnesses and their close relatives within a primary healthcare setting.

AIM: To describe the experiences of dignity encounters from the perspective of people with long-term illness and their close relatives within a primary healthcare setting. BACKGROUND: The importance of dignity as a concept in nursing care is well known, and in every healthcare encounter, the patient's dignity has to be protected. METHODS: A purposive sample of 10 people (5 couples) participated in this qualitative descripted study. One person in each of the couples had a long-term illness. Conjoint interviews were conducted and analyzed with an inductive qualitative content analysis. RESULTS: The analysis resulted in three themes: i) Being supported by an encouraging contact; ii) Being listen to and understood; and iii) Being met with respect. Couples described being encountered with dignity as having accessibility to care in terms of being welcomed with their needs and receiving help. Accessibility promoted beneficial contact with healthcare personnel, who empowered the couples with guidance and support. Couples described a dignity encounter when healthcare personnel confirmed them as valuable and important persons. A dignity encounter was promoted their sense of feeling satisfied with the care they received and promoted safe care. Treated with dignity had a positive impact on the couples' health and well-being and enhanced their sense of a good impression of the healthcare personnel within the primary health care. CONCLUSIONS: Healthcare personnel must regard and consider people with long-term illnesses and their close relatives' experiences of dignity encounters to gain an understanding that enables them to support their needs and to know that the care is directed toward them.

Participating in the Illness Journey: Meanings of Being a Close Relative to an Older Person Recovering from Hip Fracture-A Phenomenological Hermeneutical Study.

When an older person suffers an acute event, such as a hip fracture, it influences the whole family. Research shows that while close relatives want to be a part of the older person's life during recovery it is associated with a high perceived level of stress and burden. To provide in-depth knowledge of close relatives' experiences in this situation, the aim of this study was to elucidate meanings of being a close relative to an older person recovering from hip fracture surgery.This study has a qualitative descriptive phenomenological hermeneutical design. Narrative interviews were conducted with ten close relatives. Analysis was conducted using phenomenological hermeneutical interpretation which provided a deeper understanding of the close relatives' lived experiences of their older person's recovery from hip fracture surgery. The structural analysis revealed two themes; "Participating in the illness journey", which was constructed of the subthemes of facing the unimaginable yet expected, encountering healthcare personnel, and noticing recovery and "Putting oneself aside", which was constructed of the subthemes of placing daily life on hold, giving support, and feeling concern and fear.

Living with an ever-present breathlessness: Women's experiences of living with chronic obstructive pulmonary disease stage III or IV.

BACKGROUND: Living with chronic obstructive pulmonary disease stage III or IV has a major impact on a person's everyday life. This qualitative study focuses on women with chronic obstructive pulmonary disease stage III or IV. AIM: The aim of this study was to describe women's experiences of living with chronic obstructive pulmonary disease stage III or IV. METHOD: A purposive sample of fifteen women with chronic obstructive pulmonary disease stage III or IV participated in the study. Data were collected through individual semi-structured interviews that were subjected to qualitative content analysis. FINDINGS: One theme was identified, stabilizing an ever-present breathlessness by restoring strength, and three categories are as follows: managing a restricted everyday life as an expert of their illness, being afraid of contracting infections leading to suffocation and suffering and importance of continuous help and support from significant others and digital media. Breathlessness restricted women with chronic obstructive pulmonary disease, living with a body they have to wait for. Managing everyday life was adapted to their limited abilities and energy. This required detailed planning, good knowledge of their breathing and body. Women were afraid of contracting life-threatening infections that caused suffering, especially COVID-19. The fear leads to isolation and digital media was described as an important means of communication. Significant others gave support and help that was practical and emotional. Women with chronic obstructive pulmonary disease experienced lack of continuous help and support from healthcare professionals. CONCLUSION: Stabilizing an ever-present breathlessness by restoring strength required women with chronic obstructive pulmonary disease stage III or IV to conduct detailed planning to manage everyday life. Being afraid of contracting infections and the consequences of suffocation had increased since the pandemic COVID-19 outbreak, which led to self-isolation and an inactive everyday life. To get help, support and socialize, women used digital media.

The lived experiences of young people living with type 1 diabetes: A hermeneutic study.

AIMS: The aim of this hermeneutic study was to explore and elucidate the lived experiences of young people living with type 1 diabetes in terms of their everyday life and school in Sweden. DESIGN: A qualitative interview study with a hermeneutic approach inspired by Gadamer's thinking. METHODS: Interviews were conducted with a purposive sample of seven girls and three boys with type 1 diabetes between January and September 2017 and analysed with a hermeneutic method. RESULTS: Young peoples' everyday lives were transformed and re-organized by their illness and they parodically live a double-edged everyday life. To support young people's healthcare personnel, headmasters and teachers must understand this double-edged situation.

Meanings of participation in care for older people after hip fracture surgery and nurses working in an orthopaedic ward.

PURPOSE: The aim of this study was to elucidate meanings of participation in care for older people after hip fracture surgery and nurses working in an orthopaedic ward. METHODS: A qualitative phenomenological hermeneutical design was used. We conducted personal interviews with a narrative approach with 11 older people recovering from hip fracture surgery and 12 nurses working in an orthopaedic ward. RESULTS: The results show that for older people, participation meant being a co-creator in their own care, founded on being met with sensitivity and support, being told what is going to happen, taking responsibility and asking questions and being able to influence care. For nurses, patient participation meant meeting the patients' needs and requests by being open and allowing them to influence care while at the same time recognizing that the patients' possibility to influence care was limited. CONCLUSION: The study shows that for older people and nurses, the phenomenon of participation has similar meanings but also differences. When older people participate in their care, they become a co-creator in care and confirmed as a person. This highlights the importance of a nurse-patient relationship built on trust, connectedness and communication based on a shared understanding.

Recovery despite everyday pain: Women's experiences of living with whiplash-associated disorder.

INTRODUCTION: Living with whiplash-associated disorders (WAD) means living every day under the influence of pain and limitations. As the incidence of WAD and the related intensity of pain are somewhat higher among women than men, the aim of the present study was to describe women's experiences of living with WAD. METHODS: A purposive sample of seven women participated in individual in-depth qualitative interviews, the transcripts of which were subjected to qualitative content analysis. RESULTS: The results of the analysis suggested six themes of women's experiences with WAD: living with unpredictable pain; trying to manage the pain; living with limitations; being unable to work as before; needing support and understanding; and learning to live with limitations. The findings showed that unpredictable pain limited women's strength to engage in activities of daily life and be as active as before. Support and understanding were important for their ability to manage changes in their daily lives. CONCLUSIONS: Pain considerably affects the daily lives of women with WAD, particularly by limiting their ability to perform activities and to enjoy their professional and social lives. As women with WAD need support with managing their daily lives, nurses and other healthcare personnel should adopt a person-centred approach, in order to support such women according to their individual needs and circumstances.

Factors of importance for developing a trustful patient-professional relationship when women undergo a pelvic examination.

We examined gynecological teaching women's perception on what factors are important for developing a trustful patient-professional relationship when women undergo a pelvic examination. A qualitative research design was conducted with repeated focus group discussions. Our results show that healthcare professionals' communications skills can strengthen a trustful patient-professional relationship. Treating women with dignity could make them feel less vulnerable and make the relationship trustworthy based on respect. Thus, having the ability to identify factors important for a trustful relationship may support healthcare professional's ability to strengthen women's health issues. A trustful relationship might also affect quality of care.

'The same care providers over time who make individual adjustments and have competence' Older South Sami People in Sweden's expectations of home nursing care.

This study is part of a larger research project designed to examine the view of home nursing care from the perspective of older South Sami people in Sweden. In the present study, we present findings from the point of view of their expectations of home nursing care. The Sami are an indigenous population living in northern Sweden, Norway, Finland and the Kola Peninsula, and consist of different Sami people, of which the South Sami population is one. This population consists of approximately 2000 persons living in the central regions of Sweden and Norway. Fifty-six older South Sami people participated in the study. Semi-structured interviews were conducted over the telephone and were analysed using latent content analysis. The main findings show how older South Sami people's expectation for home nursing care contains the same care providers over time, individual adjustments and competent care providers and do not differ from the general Swedish population. Interpersonal interaction is a hallmark of nursing care and other healthcare disciplines. Ideally, interpersonal care is achieved when individual care providers have few care receivers, which promote continuity in care, individual adjustments based on the care receivers individual needs and care providers with professional and relational competence.

'Contradictions in having care providers with a South Sami background who speak South Sami': older South Sami People in Sweden's expectations of home nursing care.

The Sami are an indigenous population with multiple languages and dialects living in northern areas of Sweden, Norway, Finland, and the Kola Peninsula. The South Sami population lives in central regions of Sweden and Norway, and consist of about 2000 people. In this study, 56 older South Sami people from Sweden participated. Semi-structured interviews were conducted over the telephone and analysed through qualitative content analysis. The main findings show that older South Sami people's expectations of having care providers with a South Sami background speaking South Sami in home nursing care contain contradictions in and between participants. Participants had different preferences regarding having care providers with a South Sami background speaking South Sami in the future. When providing care to older South Sami people, individual adjustments are of importance, and our study showed that participants had different expectations despite having similar backgrounds.

The Journey Toward Taking the Day for Granted Again: The Experiences of Rural Older People's Recovery From Hip Fracture Surgery.

BACKGROUND: A hip fracture is an unexpected, subjective, traumatic experience that affects the person in both physical and emotional ways. PURPOSE: The purpose of this study was to describe rural older people's experiences of recovering after hip fracture surgery. METHODS: Thirteen individual interviews were conducted with older people. The interview texts were analyzed with qualitative content analysis. RESULTS: Patients described finding themselves in a new and vulnerable situation, dependent on others for simple everyday chores. They struggled to regain independence while staying positive, convinced that they would recover. Fear of another fall, as well as lack of information, made recovery at home difficult. CONCLUSION: Older people who experience hip fractures need support during the recovery process. Because recovery begins at the hospital, this study highlight patients' need to participate in recovery planning, as well as the need to have information about what it means to be affected by a hip fracture and how to prevent it from happening again. This study emphasizes that nurses' awareness of patients' need to participate in planning the recovery process is crucial for enabling patients' return to a daily life that is similar to their prefracture life.

Living with type 1 diabetes as experienced by young adults.

AIM: Describe young adults` (19-30 years) experiences of living with Type 1 Diabetes (T1D). BACKGROUND: Young adulthood is characterized by adaption to adult roles, gradual separation from parental support and leaving the parental home. Living with T1D in young adulthood raises challenges and concerns. DESIGN: This study has a qualitative design. METHODS: Semistructured interviews with 12 young adults living with T1D for 3-14 years, analysed with qualitative content analysis. RESULTS: The analysis revealed contradictory ways of handling the illness, as is illuminated in two main categories (a) and five subcategories (b). Handling the situation and dealing with different opinions (a), (b) managing daily life, emotional roller coaster and general attitudes, own views and apprehensions, ignorance and lack of motivation. Most participants were motivated, had knowledge and were in control of their long-term illness. Planning and structure were an essential part of their daily life. The participants were anxious about losing control of their bodies, the situation, die or be a burden to other people.

Being Facilitators in a Challenging Context-School Personnel's Experiences of Caring for Youth with Diabetes Type 1.

PURPOSE: The purpose of the study was to describe school personnel's experiences of caring for youth with diabetes type 1. DESIGN AND METHODS: A qualitative design was chosen for this study. Data were collected with individual interviews that were subjected to inductive qualitative content analysis. The sample consisted of 24 school personnel (teachers, principals and school nurses) from Swedish schools. All had experience with youth aged 6 to 18 years old with diabetes type 1. RESULTS: School personnel experienced caring for youth with diabetes type 1 as "Being facilitators in a challenging context" and described establishing trusting relationships, finding strategies to support self-care, feeling uncertain and incapable in need of education, and dealing with unclear responsibility. CONCLUSIONS: School personnel (teachers, principals and school nurses) are key professionals supporting youth with diabetes type 1 and self-care in school. Lack of education and unclear responsibility created feelings of uncertainty and insecurity for school personnel and a need for mandatory education of school personnel regarding T1DM and self-care, including legislation was identified. IMPLICATIONS: Mandatory education should be provided for all school personnel regarding diabetes type 1, self-care and current legislation. A liason position in form of a nurse specialist should manage the education.

Patients' complaints regarding healthcare encounters and communication.

Aim: To explore patient-reported complaints regarding communication and healthcare encounters and how these were responded to by healthcare professionals. Design: A retrospective and descriptive design was used in a County Council in northern part of Sweden. Both quantitative and qualitative methods were used. Methods: The content of 587 patient-reported complaints was included in the study. Descriptive statistical analysis and a deductive content analysis were used to investigate the content in the patient-reported complaints. Results: The results show that patients' dissatisfaction with encounters and communication concerned all departments in the healthcare organization. Patients were most dissatisfied when they were not met in a professional manner. There were differences between genders, where women reported more complaints regarding their dissatisfaction with encounters and communication compared with men. Many of the answers on the patient-reported complaints lack a personal apology and some of the patients failed to receive an answer to their complaints.

Meanings of encounters for close relatives of people with a long-term illness within a primary healthcare setting.

BACKGROUND: Encounters play an important role in the relationship between healthcare personnel and the close relatives of people with a long-term illness.AimThe aim of this study was to elucidate the meanings of encounters for close relatives of people with a long-term illness within a primary healthcare setting. METHODS: Interviews using a narrative approach were conducted with seven women and three men, and the phenomenological hermeneutic method was used to interpret the interview texts. RESULTS: The structural analysis revealed three major themes: being confirmed as a family, being informed of the care, and being respected as a valuable person. Close relatives stated that they wanted to be confirmed as a family and have a familiar and trusting relationship with healthcare personnel. They valued being informed concerning the care of the ill person so that they could give support at home. It was also important to be compassionately viewed as an important person in a welcoming atmosphere based on respect and dignity.

The importance of ethical aspects when implementing eHealth services in healthcare: A discussion paper.

AIM: The aim of this paper was to discuss the importance of ethical aspects when implementing eHealth services in health care. BACKGROUND: Challenges in healthcare today include a growing older population and, as a consequence, an increased need for healthcare services. One possible solution is the use of eHealth services. DESIGN: Discussion paper. DATA SOURCES: Research literature published from 2000-2017 in CINAHL, PubMed and Scopus. IMPLICATIONS FOR NURSING: Implementing eHealth services in health care involves ethical challenges where different technologies can solve different problems in different ways. eHealth services should therefore be developed and implemented based on the patient's specific needs and conditions for use and in accordance with the healthcare professionals' presumption to provide high-quality care. CONCLUSION: To preserve patients' integrity, dignity and autonomy, healthcare professionals must include ethical aspects when implementing and using eHealth services in health care. Healthcare professionals have to take responsibility for the eHealth services introduced, explaining why and how they are implemented based on a person-centred approach. More knowledge is needed about ethical aspects when implementing eHealth services to improve the quality of care.

A second chance at life: people's lived experiences of surviving out-of-hospital cardiac arrest.

BACKGROUND: There is more to illuminate about people's experiences of surviving out-of-hospital cardiac arrest (OHCA) and how such an event affects people's lives over time. AIMS: This study aimed to elucidate meanings of people's lived experiences and changes in everyday life during their first year after surviving OHCA. METHODS: A qualitative, longitudinal design was used. Eleven people surviving OHCA from northern Sweden agreed to participate and were interviewed 6 and 12 months after the event. A phenomenological hermeneutic interpretation was used to analyse the transcribed texts. FINDINGS: The structural analysis resulted in two themes: (i) striving to regain one's usual self and (ii) a second chance at life, and subthemes (ia) testing the body, (ib) pursuing the ordinary life, (ic) gratitude for help to survival, (iia) regaining a sense of security with one's body, (iib) getting to know a new self, and (iic) seeking meaning and establishing a future. CONCLUSION: To conclude, we suggest that people experienced meanings of surviving OHCA over time as striving to regain their usual self and getting a second chance at life. The event affected them in many ways and resulted in a lot of emotions and many things to think about. Participants experienced back-and-forth emotions, when comparing their present lives to both their lives before cardiac arrest and those lives they planned for the future. During their first year, participants' daily lives were still influenced by 'being dead' and returning to life. As time passed, they wanted to resume their ordinary lives and hoped for continued lives filled with meaning and joyous activities.