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Purpose: Children's perspectives in the context of health service delivery have historically been seen as unimportant. They have been viewed as unintelligent, unable to effectively share or tell of their experiences or fully participate in their care, potentially resulting in a sense of dehumanisation. Method: The present paper illustrates children's experiences when undergoing medical procedures, using application of the eight dimensions of humanised care theoretical framework. Results: Findings from six published papers were reflectively interrogated to identify implicit findings related to the dimensions of humanised care. These implicit findings show ways of caring for childrenwhichcan lead to enhanced human sensitivity in care or conversely where the dimensions of being human are obscured to greater or lesser degrees and can result in forms of dehumanisation. Conclusions: Inadvertent dehumanising features of practice can be mediated by encouraging the inclusion of children's own lifeworld perspective and make room for their voices in both care and research. In this way the present well documented power imbalance could be addressed. Adding the value of the theoretical framework highlights areas of need for young children to be cared for as human beings. [ABSTRACT FROM AUTHOR]

Purpose: This research examines the implementation of the Icelandic Prevention Model (IPM) in Canada to identify opportunities revealed by the COVID-19 pandemic to re-design our social eco-system to promote wellbeing. This paper has two objectives: 1) to provide a conceptual review of research that applies the bioecological model to youth substance use prevention with a focus on the concepts of time and physical space use and 2) to describe a case study that examines the implementation of the IPM in Canada within the context of the COVID-19 pandemic. Method: Study data were collected through semistructured qualitative interviews with key stakeholders involved in implementing the IPM. Results: Findings are organized within three over-arching themes derived from a thematic analysis: 1) Issues that influence time and space use patterns and youth substance use, 2) Family and community cohesion and influences on developmental context and time use and 3) Opportunities presented by the pandemic that can promote youth wellbeing. Conclusion: We apply the findings to research on the IPM as well as the pandemic to examine opportunities that may support primary prevention and overall youth wellbeing. We use the concepts of time and space as a foundation to discuss implications for policy and practice going forward. [ABSTRACT FROM AUTHOR]

Qualitative research, through its illumination of people's perspectives and experiences, has contributed a particular kind of useful evidence for caring practices. Until now however, it has found its location in healthcare without making the powerful impact on humanizing practice that is its key strength. Our paper develops a conceptual framework for humanizing care, and through examples illustrates an emerging agenda that moves qualitative research into its next and overdue phase: to enter policy-making; curricula in professional education; and to be meaningfully translated into practice in ways that place people as human beings at the centre of care. This paper provides eight philosophically informed dimensions of humanization, which together, form a framework that constitutes a comprehensive value base for considering both the potentially humanizing and dehumanizing elements in caring systems and interactions. In each case, we show, with reference to published studies, how qualitative research findings are already consistent with the humanizing focus articulated in our conceptual framework. We finally describe a reciprocal relationship in which the humanizing value framework guides a dedicated focus for qualitative research, and in which qualitative research in its turn, supports the humanising emphasis because of its intrinsic features. [ABSTRACT FROM AUTHOR]

Purpose: Conduct six systematic reviews investigating for-profit private sector roles in NCD prevention and management in low- and middle-income countries (LMICs) through our a priori framework's pillars. Methods: Six systematic reviews and thematic syntheses were performed between March- August 2021, Six databases, websites of relevant organizations, and references lists of included studies were comprehensively searched. Studies published in English from 2000 onwards involving the pillar of interest, for-profit private sector, NCD prevention/management, and LMIC context were included. Results were synthesized using an inductive thematic synthesis approach. Results: Ultimately, 25 articles were included in the PPP review, 33 in Governance and Policy, 22 in Healthcare Provision, 15 in Innovation, 14 in Knowledge Educator, and 42 in Investment and Finance. The following themes emerged: PPPs (coordination; financial resources; provision; health promotion; capacity building; innovation; policy); Governance/Policy (lobbying; industry perception; regulation); Healthcare Provision (diagnosis/treatment; infrastructure; availability/accessibility/affordability); Innovation (product innovation; process innovation; marketing innovation; research; innovation dissemination); Knowledge Educator (training; health promotion; industry framework/guideline formation); Investment and Finance (treatment cost; regulation; private insurance; subsidization; direct investment; collaborative financing; innovative financing; research). Conclusion: These findings will be instrumental for LMICs considering private sector engagement. Potential conflicts of interest must be considered when implementing private sector involvement. [ABSTRACT FROM AUTHOR]

Purpose: Postpartum Depression (PPD) --a common health problem for mothers' postpartum increases the risk of negative interaction between mothers and infants as it reduces the former's ability to respond to the latter's needs appropriately. Migrant mothers exhibit a higher prevalence of risk factors for PPD. Hence, this study aimed to investigate migrant mothers' life experiences pertaining to motherhood and PPD. Methods: Qualitative interviews were conducted with 10 immigrant mothers in the south of Sweden during 2021. Results: The qualitative content analysis revealed the following main themes: 1) PPD (two sub themes--psychosomatic symptoms and burden of responsibility due to feelings of loneliness); 2) mistrust of social services (one sub-theme--afraid of losing their children and Swedish social services' lack of understanding); 3) inadequate healthcare (two subthemes-- limited healthcare literacy for migrant mothers and language barrier; 4) women's coping strategy for well-being (two sub-themes--better awareness and understanding of the Swedish system and society, and freedom and independence in the new country). Conclusions: PPD, mistrust of social services, and inadequate healthcare lacking personal continuity were common among immigrant women, thus precipitating discrimination-- including lack of access to services because of limited health literacy, cultural differences, language barriers, and insufficient support. [ABSTRACT FROM AUTHOR]

Purpose: Canadian new immigrant families (also known as newcomers) encounter challenges navigating systems when trying to access programmes critical for their children's healthy development. The purpose of this study is to understand how newcomer families find and use early childhood programmes and services from the perspective of families and early childhood educators (ECEs) working within a settlement organization. Methods: Using photovoice methodology, newcomer family members (n = 8) with young children and ECEs (n = 6) participated in a series of virtual workshops to share photos and reflect on their experiences. Results: Participants discussed the systemic barriers that obstructed newcomer families' access to services for young newcomer children. Financial challenges due to unemployment/ underemployment, language and cultural differences were emphasized. Despite these barriers and challenges, participants shared how culturally responsive programmes enhanced their connections to programmes and services. Both groups of participants discussed the critical role of social networks in supporting newcomers to use programmes by helping families become aware of available services and assistance with various processes such as registration. Conclusions: This research illustrates the lived experiences of newcomer families and identifies opportunities to address inequities, improve early childhood programmes, and enhance families' access to programmes and services. [ABSTRACT FROM AUTHOR]

Purpose: China employed a unique volunteerism system where health care providers outside of Hubei Province, the epicentre, travelled to reverse the devastation wrought by coronavirus disease 2019 (COVID-19) at its global onset. The aim is to study the unique circumstances of Chinese volunteerism in the context of continuing pandemic threats, specifically exploring the experiences of 20 Chinese nurse and physician volunteers fighting COVID-19 during the outbreak. Methods: Interviews were done through video calling. Results: Using content analysis with a hermeneutic perspective, emerging patterns showed the ways in which China's particular manifestation of volunteerism teaches us how to engage global threats of this nature. The overarching lesson, For the Good of the People, was manifested in several dynamic and overlapping themes: 1) Reaching for Professional Standards Even in Crisis; 2) Constantly Caring Through Failures and Successes; and 3) Holding Fast to the Common Good. The devastation was met by the resilience of volunteers, who overcame profound challenges managing patient care. Conclusions: Volunteerism required sacrifice and tremendous support in the form of training and administrative direction, family support, and peer collaboration. Volunteers' physical and psychosocial wellbeing was a priority. Recognizing the representative themes can help societies plan for continuing and future events. [ABSTRACT FROM AUTHOR]

Suffering and well-being are significant aspects of human existence; in particular, suffering and well-being are important aspects of patients' experiences following diseases. Increased knowledge about existential dimensions of illness and healthcare experiences may be needed in order to improve care and reduce unnecessary suffering. Therefore, the aim of this paper is to illuminate the phenomenon of suffering experienced in relation to healthcare needs among patients in hospital settings in Sweden. In this study, we used a reflective lifeworld approach. The data were analysed with a focus on meanings. The results describe the essential meaning of the phenomenon of suffering in relation to healthcare needs. The patients were suffering during care-giving when they felt distrusted or mistreated and when their perspective on illness and health was overlooked. Suffering was found to arise due to healthcare actions that neglected a holistic and patient-centred approach to care. Unfortunately, healthcare experiences that cause patients to suffer seem to be something one needs to endure without being critical. The phenomenon can be described as having four constituents: to be mistreated; to struggle for one's healthcare needs and autonomy; to feel powerless; and to feel fragmented and objectified. The study concludes that there are problems associated with patients experiencing suffering at the hands of healthcare providers, even if this suffering may not have been caused deliberately to the patient. Consequently, conscious improvements are needed to lessen the suffering caused by care-giving, as are strategies that promote more patient-centred care and patient participation. [ABSTRACT FROM AUTHOR]

From nurses to dentists and doctors, caregivers undergo significant initial and life-long training. This training, however, rarely addresses the subjective side of their practice, especially the lived experience of caregiving. Better understanding this experience can nevertheless help to build fruitful relationships with patients. We focus on what it is like to take care of someone else and attempt to outline an encompassing "phenomenology of care". We investigate the lived experience of caregivers during their first meeting with a patient. We rely on micro-phenomenological interviews, which offer fine-grained, first-person descriptions of someone's holistic experience in a given situation. We show how the subjective experience of meeting a new patient can be structured with i) categories of micro-experiential acts (gathering information, assessing and performing actions), ii) the scopes of these acts, which involve inner and outer perceptions, various elaborations, regulations and interventions and iii) a range of experiential modalities. We highlight the richness of lived experience, and what all caregivers intimately share beyond the frame of their respective professions and practices. We discuss our results in terms of methodology, finalized and productive activities, pre-reflective aspects, and reflexive practice. [ABSTRACT FROM AUTHOR]

Role expectations of physicians providing health care for hunger strikers have been discussed in the context of prisons and detention centres. Ethical guidance for physicians in these situations is codified in the Declaration of Malta. In the last years, new forms of collective, public hunger strikes of asylum seekers have occurred. We have aimed at reconstructing the experiences of health-care personnel involved in one of such cases. Semi-structured interviews with nine participants (physicians and paramedics) that had been involved in a public collective hunger strike of asylum seekers in Germany were conducted. We identified three health-care provider groups: voluntary physicians, emergency service providers and medical consultants for the authorities. Role conflicts arising from multiple loyalty situations with obligations towards different stakeholders (e.g., strikers, employers, authorities) were perceived as the greatest challenge especially for voluntary doctor and emergency service provider participants. Such conflicts culminated in feeling instrumentalized for political goals. The results illustrate that professional challenges in the health care during a public collective hunger strike differ in various aspects from those described in the literature on custodial settings. We recommend expanding and adapting the medico-ethical guidance. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses various articles within the issue on topics including the transformation of caring science into public health, caring science education, and the relationship between cultural care and caring science.

Purpose: Although social capital influences health-related decisions and behavioural patterns in many developing countries, minimal attention has been paid to the nuances of its effect on healthcare. This paper examines how bonding social capital affects healthcare delivery for inpatients in Ghana. Methods: Semi-structured in-depth interviews were used and thematic analysis method employed to analyse the data. Interviews were conducted with health professionals and relatives and close friends of inpatients in three public health facilities in Ashanti region. Results: Relatives and close friends of inpatients were a critical source of instrumental support such as provision of meals, laundry services, running errands and financial assistance as well as emotional support. These functions—that were both 'expected' and 'encouraged'— reduced the burden on the health facilities, which apparently had limited resources to offer adequate care. However, the relatives of inpatients sometimes inadvertently obstructed efficient healthcare delivery through actions such as extending 'unapproved' alternative care to patients. Moreover, the process of contributing towards health and well-being of the sick exposed the relatives to health risks due to poor living conditions. Conclusion: A well-defined and befitting role must be devised for at least an immediate social relation of inpatients to improve the positive effects of bonding social capital on healthcare delivery. [ABSTRACT FROM AUTHOR]

Despite evidence that older persons want to be involved in care, little is known about how frail older people with significant care needs living at home experience participation in care provided by different stakeholders. This study investigates the experiences of participation in care by older people following their involvement in an intervention of a health care model called Focused Primary care (FPC). Individual semi-structured interviews were conducted with 20 older persons in five municipalities in Sweden. The results show that older persons highlighted opportunities and limitations for participation on a personal level i.e., conditions for being involved in direct care and in relation to independence. Experiences of participation on organizational levels were reported to a lesser degree. This included being able to understand the organizational system underpinning care. The relational dimensions of caregiving were emphasized by the older persons as the most central aspects of caregiving in relation to participation. Primary care should involve older persons more directly in planning and execution of care on all levels. An ongoing connection with one specialized elderly team and a coordinating person in Primary care who safeguards relationships is important for providing participation in care for frail older persons with significant care needs living at home. [ABSTRACT FROM AUTHOR]

Purpose: This study examined what support cancer patients and their close ones need and how this support should be organized when developing cancer care pathways. The study focused on the opinions of professionals of the Cancer Society of Finland (CSF), who play a central role in presenting the third sector's perspective on care pathways. Method: Six semi-structured group interviews were carried out with counselling nurses (n = 12) and managers (n = 9) of the CSF during summer 2017. The results were analysed using content analysis. Results: Both patients and their close ones need more information, psychosocial support and financial counselling after diagnosis, during rehabilitation and follow-up, at relapse and during the palliative care phase; additionally, close ones require support after the patient's death. Participants emphasized close collaboration between public healthcare and the CSF to meet the needs of patients and their close ones. Conclusion: Psychosocial support can—and should—be provided as part of the care pathway. This support can be provided by organizations in the third sector, such as the CSF, which have resources in this area. [ABSTRACT FROM AUTHOR]

The article presents several qualitative studies to be presented at the 4th Nordic Interdisciplinary Conference on May 18-20, 2006 in Sweden. They include qualitative study of how spinal cord injury patients recreate meaning during rehabilitation period by Sanne Angel, parents' experience of having a child with autism and intellectual disabilities living in a group home by Ylva Benderix and conceptions of xerostomia among health care professionals by Solgun Folke.

A letter to the editor is presented which discusses how qualitative researchers can enhance the quality of their studies.

Immigrant patients run a risk of receiving lower quality of care. Co-production, as the concept of how to collaboratively create valuable healthcare service for the patient, offers a new perspective that might help. The scoping review aimed at identifying and analysing factors facilitating co-production between immigrant patients and healthcare professionals. We searched seven scientific databases for peer-reviewed publications of all study designs. Two reviewers independently screened the publications for eligibility and performed data extraction. Data were analysed by applying an inductive, interpretive approach for data synthesis. Fifteen publications were included for analysis. We identified six factors hat facilitate co-production: 1) prioritizing co-production in the organization, 2) providing a safe environment that promotes trust and patience, 3) using a language the patient understands, 4) respecting the patient's knowledge and priorities, 5) improvising with knowledge and courage, and 6) engaging in self-reflection. The scoping review illustrated that co-production with immigrant patients can be successful if the system and professionals are interested and prepared. Immigrant patients could be a valuable source of information and powerful co-producers of their own health. The study contributed to a growing body of research on patient-professional co-production in healthcare and might also prove relevant for other disadvantaged patient groups. [ABSTRACT FROM AUTHOR]

Although user participation and shared decision-making in formal statutory coordinated care planning are described as central, they remain to be implemented. The aim of this study is to explore how collaboration and shared decision-making in the social services can be realized in formal care planning activities with people with mental disabilities. We conducted eight workshops with 12 users and 17 caregivers to investigate existing barriers to and possible solutions for participation in coordinated care planning. Workshop formats and techniques from participatory design generated rich research materials illustrating challenges currently experienced by users and caregivers in care planning work, as well as a large variety of solutions to these challenges. They also illustrated differences in how participation is understood and the conditions required to realize shared decision-making between users and caregivers. An improved coordinated individual plan (CIP) process emerged, based on the active participation of users and caregivers. This process is a familiar and transparent process for users and caregivers, reflecting the needs and preferences of users at all stages. It requires careful preparation and collaboration with the users, as well as caregiver flexibility. [ABSTRACT FROM AUTHOR]

Purpose: This study explored whether the holistic theory of salutogenesis may be a suitable theoretical framework for the Clubhouse model of psychosocial rehabilitation, a pioneer among psychosocial rehabilitation programmes. Methods: A systematic examination of elements of the Clubhouse model, as prescribed by the Clubhouse standards, was performed within the context of the theory of salutogenesis including its basic salutogenic orientation and the main concepts of sense of coherence and resistance resources. Results: We found that several standards and practices within the Clubhouse model can be understood as applications of salutogenesis. We have hypothesized that the Clubhouse model promotes peoples' sense of coherence and mental health. However, our investigation also showed that, to enhance the recovery of Clubhouse members, more explicitly incorporating some salutogenic principles, such as "appropriate challenges" and "active adaptation as the ideal in treatment", may benefit Clubhouse practice. Conclusions: The Clubhouse model of psychosocial rehabilitation is very consistent with the salutogenic orientation and main salutogenic concepts. The present study suggests that salutogenesis may be a suitable theoretical framework for the Clubhouse model and possibly in the psychosocial rehabilitation field in general. [ABSTRACT FROM AUTHOR]

Purpose: To explore the methods through which physicians deliver compassionate care during end-of-life (EOL). Compassionate care provides benefits to patients and providers and is particularly important for patients with serious illnesses, yet its practice remains limited. We aim to qualitatively characterize methods utilized by physicians that facilitate the delivery of compassionate care at EOL. Methods: We conducted 13 semi-structured interviews with physicians from palliative care and medical oncology subspecialities at a rural academic medical centre in New Hampshire. Interviews were transcribed and analysed using a qualitative research design. Results: Participants described methods of compassionate care ranging from symptom control to less tangible, non-verbal methods. Primary barriers to the delivery of compassionate care were described as within the broader healthcare system and within the inherent emotional difficulty of EOL care. Physicians from both subspecialities emphasized the importance of successful inter-provider relationships. Conclusions: Methods for delivering compassionate care at EOL are wide ranging, but barriers on a systemic and individual level should be addressed to make its practice more widespread. This can be accomplished, in part, by the standardization of EOL conversations, training physicians how to have meaningful EOL conversations, and integration of such conversations into electronic medical records. [ABSTRACT FROM AUTHOR]

Purpose: This article explores first-hand accounts of Canadian bariatric patients' experiences of seeking and obtaining weight loss surgery abroad through the practice of medical tourism. While researchers have identified many of the challenges and associated health and safety risks imposed on patients by engaging in medical tourism generally, little is known about the specific challenges experienced by Canadians seeking bariatric surgery abroad.Method: To better understand these challenges, we conducted thematic analysis on interviews conducted with 20 former Canadian bariatric tourists.Results: Our analysis illuminated three key challenges Canadians face in obtaining bariatric care: (1) stigma and isolation from friends, family and medical professionals; (2) self-directed navigation of domestic and destination health care systems; and (3) challenges with obtaining adequate follow-up care in Canada.Conclusions: While these challenges identified by participants may occur in other forms of medical tourism, it appears that these challenges are occurring simultaneously in cases of bariatric tourism by Canadians. These challenges appear to work in conjunction to heighten the health and safety risks potential Canadian bariatric tourists may be exposed to. Unless structural changes occur to increase domestic availability of bariatric surgery, Canadians are likely to continue seeking this care abroad. [ABSTRACT FROM AUTHOR]

Purpose: Access to primary care can help mitigate the negative impacts of social inequity that disproportionately affect Indigenous people in Canada. Despite this, however, Indigenous people cite difficulties accessing care. This study seeks to understand how Indigenous mothers—typically responsible for the health of their infants—living in urban areas, experience selecting and using health services to meet the health needs of their infants. Results provide strategies to improve access to care, which may lead to improved health outcomes for Indigenous infants and their families. Methods: This qualitative interpretive description study is guided by the Two-Eyed Seeing framework. Interviews were conducted with 19 Indigenous mothers and 5 primary care providers. Results: The experiences of Indigenous mothers using primary care for their infants resulted in eight themes. Themes were organized according to three domains of primary care: structural, organizational and personnel. Conclusions: Primary care providers can develop contextual-awareness to better recognize and respond to the health and well-being of Indigenous families. Applying culturally safe, trauma and violence-informed and family-centred approaches to care can promote equitable access and positive health care interactions which may lead to improved health outcomes for Indigenous infants and their families. [ABSTRACT FROM AUTHOR]

Purpose: Promoting a child's healthy growth and development in the first six years of life is critical to their later health and well-being. Indigenous infants experience poorer health outcomes than non-Indigenous infants, yet little is understood about how parents access and use health services to optimize their infants' growth and development. Exploring the experiences of Indigenous mothers who select and use early childhood development (ECD) services provides important lessons into how best to promote their access and use of health services. Methods: This qualitative interpretive description study was guided by the Two-Eyed Seeing framework and included interviews with 19 Indigenous mothers of infants less than two years of age and 7 providers of ECD services. Results: Mainstream (public) and Indigenous-led health promotion programs both promoted the access and use of services while Indigenous-led programs further demonstrated an ability to provide culturally safe and trauma and violence-informed care. Conclusions: Providers of Indigenous-led services are best suited to deliver culturally safe care for Indigenous mothers and infants. Providers of mainstream services, however, supported by government policies and funding, can better meet the needs of Indigenous mothers and infants by providing cultural safe and trauma and violence-informed care. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to gain a deeper understanding of elderly long-term care facilities by focusing on insights provided by the operators of these facilities. Methods: In this phenomenological study, 10 participants who operated nursing home businesses were interviewed. Of the 10 participants, seven had graduated from a nursing programme and three had studied social welfare. Results: The experiences of facility operators could be organized into four themes: "Starting as a facility operator", "Dream of an ideal long-term care facility", "Struggling desperately in practice", and "Obtaining hope by providing care". These four themes were divided into 18 subthemes, constituting 96 meaningful statements. Conclusion: Despite the obvious gap between reality and ideals with regard to caring for residents, operators used a person-centred care strategy for the elderly at their facilities. Our findings indicate that, despite diverse barriers and hardships, participants were encouraged when they offered person-centred healthcare services for the elderly under their care, based on a philosophy of a holistic understanding of humans and respect for human life and dignity. Facility operators who are leaders in the practical field should be involved in the decision/policy-making process, to support health and well-being in the elderly in institutionalized settings. [ABSTRACT FROM AUTHOR]

The article focuses on the paper of Professor Peter D. Ashworth to be presented at the 4th Nordic Interdisciplinary Conference in Sweden. It discusses on the roles played by health care professionals in giving aid to patient's needs. The care given by health professionals to patients can be enhanced through an understanding of the patients medical needs. Furthermore, the assistance and concern shown to patients constitute the elements in the caring activity.

In bringing ourselves to the encounter with the experience of others, we bring our bodies with us*and, in doing so, we are able to resonate not only intellectually but also empathically with the other's experiences and expressions (which are given to us both verbally and nonverbally). In remaining faithful to our foundations in phenomenology (Husserl, Heidegger, Merleau-Ponty, and Levinas), we shall talk about taking notice of others from within the relational ''exchange'' and reflect upon what, precisely, are the experientially given ''affairs'' to which Husserl invited us to return. Our interest begins with the other's ''first person'' experience, but since we cannot access this directly, we must rely on the resonance we find within ourselves, within our own lived bodies, when we are addressed by the other, whether in word or in gesture. I am wondering what the other is experiencing and all my powers of perception are driven toward this other, whose first person experience remains just out of reach and accessible only insofar as I have this capacity for a deeper ''bodily felt'' awareness in which the other's experience takes possession of me. Merleau-Ponty's notion of bearing ''witness'' to behavior is useful in illuminating this ''second person'' perspective, which takes its point of departure from Husserl's (1910-1911) intersubjective reduction, by means of which we ''participate in the other's positing'' (1952/1989, emphasis added) and thereby grasp the meaning of the other's expression. Ultimately, the intuitive talent of the caring professional will be shown to reside in his or her being able to move beyond what the other is able to say to a more deeply felt attunement to what is being revealed to us in the other's presence. Applications to patient care are discussed. [ABSTRACT FROM AUTHOR]

This qualitative interview study focuses on the personal experiences of partners to a spinal cord injured person. Using a Ricoeurian phenomenological-hermeneutic approach, we analysed seven partners' narratives 1 and 2 years after their partner's injury. The study revealed how the injury was experienced from the partners' perspective through the aftermath. In the acute phase after the injury, partners also felt harmed, and support was needed in relation to their own daily activities, eating, resting, and managing distress. During the institutionalized rehabilitation, partners felt torn between supporting the injured partner and the demanding tasks of everyday life outside the institution. After discharge, partners struggled for the injured partner to regain a well-functioning everyday life and for reestablishing life as a couple. The partner struggled to manage the overwhelming amount of everyday tasks. Some sought to reestablish their usual functions outside the family, whereas others focused on establishing a new life together. The partners experienced much distress and appreciated the support they got, but felt that they were mainly left to manage the difficult process on their own. [ABSTRACT FROM AUTHOR]

The aim of this qualitative study is to explore the way people using modern health care perceive its consequences in Ouraman-e-Takht region of Iranian Kurdistan. Ouraman-e-Takht is a rural, highly mountainous and dry region located in the southwest Kurdistan province of Iran. Recently, modern health practices have been introduced to the region. The purpose of this study was to investigate, from the Ouramains' point of view, the impact that modern health services and practices have had on the Ouraman traditional way of life. Interview data from respondents were analyzed by using grounded theory. Promoting survival was the core category that explained the impact that modern health practices have had on the Ouraman region. The people of Ouraman interpreted modern health practices as increasing their quality of life and promoting their survival. Results are organized around this core category in a paradigm model consisting of conditions, interactions, and consequences. This model can be used to understand the impact of change from the introduction of modern health on a traditional society. [ABSTRACT FROM AUTHOR]

Spirituality is a contested concept with a wide taxonomy of meaning discussed in the literature. Within the domain of health care, there has been increasing interest in the importance of understanding and valuing patients' individual spirituality as a function of providing appropriate support, particularly as part of nursing practice. This article reports on an ethnographic participant observation study that explored the cancer day care provision of a community hospice trust located in Southern England. The aims of the study were to explore why users of day care came to the sessions and the perceived benefits of attending. Secondary analysis of the data undertaken after initial reporting on the findings has revealed the ways in which participants construct their core life meaning as personal spirituality. Drawing on literature that discusses the multi-faceted concept of spirituality, the data suggest that relationships and citizenship work are key spiritual components in the lives of these participants, with both these elements significantly contributing to the maintenance of a congruent “self”. “Doing” rather than “being” is at the core of spiritual essence for those undertaking citizenship work, with this engagement with the world as one form of transcendence. [ABSTRACT FROM AUTHOR]

Empirical research has shown that household and neighbourhood characteristics are significantly linked to particular health-behaviour profiles. Specifically, people living in lower socioeconomic living contexts tend to be associated with less active and healthy lifestyles. However, what is not yet fully understood is how living contexts work to produce and sustain common or shared behavioural patterns. To address this question, we employed Berger and Luckman's social constructionist conceptualisation of context to study a group of residents who had recently moved from poorer living contexts to a mixed-tenure, inner city, new urban village equipped with various resources promoting a physically active lifestyle. This framework was coupled with Charmaz' social constructionist approach to grounded theory. An analysis of the qualitative data gave rise to the conceptual categories of “being flogged up something fierce”, “running away”, “sleeping with one eye open”, “you're just fat”, and “exercise as a dream” as the key contextual influences mediating poor living contexts and low physical activity levels. A core category of “identity management” was located. The selection of this case and the findings exhibited here draw attention to the need for a situated understanding of how particular lifestyles develop in socioeconomic living contexts. The insights need to be drawn from 'insider perspectives' in order to ensure more sensitive and effective interventions in the future. [ABSTRACT FROM AUTHOR]

Developing the best care for clients and patients is a paramount aim of all health care practices, which therefore, should be based on best evidence. This is also crucial for care during the childbearing period here defined as pregnancy, childbirth, and infancy. However, due to dominance of the evidence-based medicine (EBM) model, health care practice has encountered problems especially regarding its relationship to qualitative research. In this article, we analyze and discuss how research based on a lifeworld perspective fits with evidence-based care (EBC), and how a circular model instead of a hierarchy is suitable when attributing value to knowledge for EBC. The article focuses on the history of EBM and EBC, the power of the evidence concept, and EBC from a narrow to a broad view. Further qualitative research and its use for developing EBC is discussed and examples are presented from the authors' own lifeworld research in the Nordic childbearing context. Finally, an alternative circular model of knowledge for EBC is presented. In order to develop evidence-based care, there is need for multiple types of scientific knowledge with equal strength of evidence, integrated with clinical experience, setting, circumstances and health care resources, and incorporating the experiences and clinical state of the childbearing woman and her family. [ABSTRACT FROM AUTHOR]

This article reports on a flexibly designed study evaluating the experience of participants with a range of health and life difficulties in a community-based mindfulness-training group. We describe the way we set up the group explicitly as a 'facilitated self help' group over 20 weeks in the environment of a community centre, with inclusive membership. We show similarities and differences in this approach with other mindfulness groups, in particular highlighting our desire to avoid presenting mindfulness as a “treatment”. A thematic analysis was applied to transcribed audio-recordings from multiple talk-based data sources. The analysis showed that participants found the group to be a safe and productive space in which to learn and consolidate a new skill. Participants also described both the group and mindfulness itself as, at times, an uncertain and difficult challenge, partly connected with what could be described as the slippery nature of mindfulness. Participants reported the positive impact of mindfulness in facilitating both enhanced appreciation of everyday life experiences, and greater resilience in the face of difficulties. In the concluding sections we explore the implications of this “slippery-ness” and of our approach both to the group itself and the research process, and ponder the uncertainties and paradoxes of mindfulness as a “tool for life”. [ABSTRACT FROM AUTHOR]

The phenomenon in focus for this study was the sexual identity preserved in premenopausal women due to breast cancer treatments. During the last decade the methods of breast cancer treatments have become more aggressive and many women have had to undergo surgery, radiation, and chemotherapy, as well as three to five years of hormone therapy. All these forms of treatment can have negative side effects on their sexual capability. The purpose of this study was to describe the meaning structure and the constituents of sexual identity in the lifeworld of premenopausal women. Six informants who had become menopausal following cancer treatment were interviewed about their experiences related to their sexual identity. Their ages varied between 38 and 48 years. The empirical phenomenological psychological (EPP) method was used. The meaning structure of the phenomenon could be symbolized using the metaphor of a bird which is pinioned and unable to fly. The women perceived their sexual identity as being inhibited in different ways. They felt odd and marginalized as women, and it was only within a support group that they felt completely confirmed. A future challenge for the health care professionals would be to care for their patients on the basis of their lifeworld experiences. [ABSTRACT FROM AUTHOR]

Feeding completely dependent persons is a common activity in many health care settings; however, it has received relatively little attention by researchers. Recently, there has been a call for nurses to revisit some of the so-called "basic" tasks that have been eliminated from nurses' responsibilities and relegated to non-professional staff. This article details an analysis of the findings of ten published qualitative research reports about feeding completely dependent persons who are elderly. Drawing on procedures of meta-ethnography described by Noblit and Hare (1988), Meta-Ethnography: Synthesizing qualitative studies Newbury Park: Sage Publications) and later by Paterson, Thorne, Canam, and Jillings (2001), Meta-study of qualitative health research. A practical guide to meta-analysis and meta-synthesis Thousand Oaks: CA Sage Publications), the authors identify two central themes within the primary research; feeding as task and feeding as relationship. Based on the meta-ethnographic findings, two areas for future research are suggested; exploring structural and institutional influences on the feeding practices of health care providers and exploring how nurses mediate the tension between the relationship and task perspective of feeding completely dependent persons. [ABSTRACT FROM AUTHOR]

This study is part of a larger project, the aim of which is to elucidate "mental health nurses" attitudes towards their patients'. In this study, nurses' and patients' attitudes are described from the perspective of both parties using a qualitative approach. The informants were selected from a rehabilitation unit for young adults, below 40, suffering from psychosis at a psychiatric clinic that provides acute psychiatric care. The informant group consisted of three dyads: three patients with various diagnoses and three nurses with primary responsibility for the patients' daily care. The aim of this particular study was to extend our preliminary understanding of nurses' attitudes towards psychiatric patients in the context of psychiatric in-patient care, by elucidating the patient's "inner" picture of her/his past, present and future and the nurse's picture of the same patient's past, present and future. Data were collected and analysed using a phenomenological-hermeneutic approach and the narrative picturing technique. For each picture and group, 15 related sub-themes emerged, on the basis of which six themes were formulated. The findings show that the nurses overrate their own importance when it comes to the patient's well-being on the ward. All the nurses emphasize confirmation and safety as the basis of their nursing care, while in the patient's picture the nurses represent a replication of childhood demands, which probably means that nursing care risks becoming a continuation of the patient's childhood estrangement. [ABSTRACT FROM AUTHOR]

Some philosophers of science and social scientists disapprove of using empathy in human inquiry. Empathy would be neither sufficient nor necessary for understanding another person. In this article, the insufficiency of empathy will be recognized, but the necessity of empathy for interpersonal understanding in everyday life, situations of professional care, and certain forms of human inquiry, especially qualitative research, will be supported. However, empathic understanding should not be conceived as pure psychic identification, but rather as putting oneself imaginatively into the experiential world of another person with the aim to understand the other. Emotional resonance is not only an early phase of it, but also a basic facet. A comprehensive conceptualization of empathic understanding is developed, which makes empathy more worthwhile in professional contexts. Empathic understanding is conceived as a two-dimensional concept. The mental dimension refers to affective, cognitive, and interpretive facets or phases of empathic understanding and the social dimension refers to expressive, responsive, and interactive facets or phases of empathic understanding. These two dimensions are crosswise combined and the most optimal form of empathic understanding is called “dialogical-hermeneutical empathic understanding.” In addition, the importance of imagination and the development of it for optimal empathic understanding are elaborated. [ABSTRACT FROM AUTHOR]