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Background and aim: The aim of the present article was to elaborate on a research approach and method called 'lifeworld hermeneutics'. Significant to lifeworld hermeneutics is that interpretation is the main methodological instrument for explaining and understanding existential research questions and lived experiences. From a caring science perspective, this often refers to research that aims to gain a deeper understanding of existential phenomena and issues, such as existential meaning of health, well‐being, homelessness, lostness, suffering and ageing, as well as what it means to experience unhealthiness and illness, the need for care, and caring that responds to such needs. Design: Theoretical paper. Result: The article briefly covers ontology and epistemology that clarifies the meaning and importance of a lifeworld hermeneutic attitude. This is followed by suggestions for how to perform a lifeworld hermeneutic study, expressed in relation to methodological principles for the interpretation, validation and structuring of interpretations. Thereafter, follow reflections on how to use theoretical or philosophical support to develop and deepen existential interpretations. The findings of lifeworld hermeneutic research consist of existential interpretations where the researcher, with an open and pliable attitude towards the phenomenon and the aim of the study, clarifies, explains and suggests new ways of understanding participants' lived experiences; the researcher should maintain such an attitude towards their understanding of the phenomenon as well. Conclusion: The lifeworld hermeneutical approach and method described in this article makes it possible to further deepen the understanding and knowledge about existential issues that is relevant for caring and caring science. [ABSTRACT FROM AUTHOR]

Background: When the ageing population increases, the burden and responsibility of close family members will likely increase. Those closely related who assume a great responsibility can be significantly affected in health, well‐being and daily life. Aim: This study aims to describe the life situation when family caregivers are imposed responsibility for an older person with complex care needs in their own home. Methods: In this Swedish qualitative study, ten family caregivers were strategically selected in order to achieve variations in the life situation. A reflective lifeworld research design based on phenomenological philosophy was used throughout the data collection with the lifeworld interviews and the analytic process. Findings: In terms of extensive responsibility, the life situation is complex and involves emotions that are difficult to manage. In essence, a paradoxical life situation is described which is experienced as both voluntarily and nonchosen at the same time. The responsibility never rests. The essential meaning is further illustrated with three constituents: loss of freedom, contradictory feelings and affected relationships. Conclusion: A life situation with extensive responsibility for an older family member interferes with the whole life situation with an impact on health and relationships with other people. The findings are crucial for professional caregivers in order to capture the nature of family support in a way that enables a meaningful life for both the family caregiver and the older person being cared for. Knowledge of this will give professional caregivers an increased awareness of the life situation of family caregivers and provide a better understanding of the support they are longing for, and, in some countries, such as Sweden, also are entitled to by law. [ABSTRACT FROM AUTHOR]

Aim and objective: To describe the meaning of the phenomenon home care from the perspective of older persons who live alone with multimorbidity. Background: In line with worldwide changing demographics, conditions for older people in need of home care are changing. In Sweden there is a stay‐in‐place policy and older people are expected to live and be cared for in their own home as long as possible. Home care, instituted by different laws, is a challenge affecting the older person when the private home becomes a workplace. Design: This study uses a qualitative design with a lifeworld approach. Methods: The study having been conducted in Sweden in 2016, the researchers interviewed 12 older persons that live alone and receive home care. Data were analysed using qualitative content analysis. Results: The findings illustrate four sub‐themes: adapting to a caring culture, feeling exposed, unable to influence care and forced relations. The overall theme reveals that older people experience a life‐changing situation when receiving home care and they become a guest in their own home. Conclusions: Becoming older with increased needs means to disrupt one's life when one's private home becomes a public arena. The gap between an older person's rights by law and the older person's experiences of receiving home care needs to be highlighted to meet the oncoming challenges in providing a home care that includes participation of the older themselves. Only then can care be offered that enables older people to have a sense of control and experience their home as their own. Implications for practice: The findings emphasise the need to view older people as being self‐determinant and independent. Older people receiving home care need to be seen as individuals, and their entire life situation should be considered by also acknowledging the important role played by relatives and caregivers. [ABSTRACT FROM AUTHOR]

ABSTRACT The life of close relatives of persons with bipolar disorder (BD) is associated with emotional distress, depression, and a high level of use of mental health care. Illness-related changes of their life situation endanger relationships, social life, finances, and occupational functioning. Understanding of facilitating conditions for close relatives is still a neglected research area. The aim of the present study thus was to explore what makes the life of close relatives of persons with BD more liveable. A lifeworld phenomenological approach was used. The findings reveal that keeping distance, having stability in everyday life, and strengthening equality through transparent communication are conditions that enable close relatives to influence the unpredictable and its consequences and thus make life more liveable. This implies contributions from close relatives, the person with BD, and the caring services. We propose that health-care support should not be divided in support for the patient and/or the close relatives but instead be designed as support for the 'patient and close relatives' as a unit. Professional caregivers need to take responsibility for creating intersubjective settings for the person with BD and their close relatives to share their needs and make joint plans for how to influence the illness-related life issues. [ABSTRACT FROM AUTHOR]

Aims and objectives. The aim of this study was to complement ‘expert’ knowledge about speech-language therapy by studying the phenomenon of professional aphasia care from the patient’s perspective. Background. The methods for assisting patients with aphasia have mainly been based on speech language therapy with methods for training language. However, the effectiveness of mereley training has not been conclusively proven. In this study, it was assumed that patients with impaired use of language require professional caring interventions as a base for training. Design. A phenomenological approach was used to gain understanding of patients’ lived experiences of professional aphasia care. Method. Data consisted of eight in-depth interviews, four follow-up interviews, two notes from diaries and two biographies. Data were analysed according to a descriptive phenomenological method. Results. The essential meaning of the phenomenon was: trusting the patient’s competence while facing existential issues. To enhance understanding, the essential meaning was specified in terms of the following constituents: preventing isolation, straightforwardness, provision of security, recognition of caring needs, encouraging efforts to practise language, equality and supporting maintenance of identity. Conclusions. This study adds to the knowledge about speech-language therapy that professional aphasia care presupposes a secure base and a carer who recognises and trusts the patient’s ability to think and communicate. Relevance to clinical practice. Implications for clinical practice are outlined under the following main headings, a secure caring base, encourage a fighting spirit and expressions of feelings, facilitate communication, try to understand the patient’s existential situation and enable patients to recognise that their self-image derives from the painful experience of losing the world of symbols. Inside is the same person and carers should make it clear that they are aware of that. [ABSTRACT FROM AUTHOR]

Since Hildegard Peplau's interpersonal relation model for psychodynamic nursing, in the 1950s, many theories about humanity have been expanded in the discipline of nursing. For this purpose Rosemarie Rizzo Parse, for example, synthesized principles and concepts from Martha Rogers with existential phenomenology, when she introduced the idea of a simultaneity paradigm as unique for the discipline of nursing in opposition to Peplau's psychodynamic model. The aim of this paper is to discuss borrowed theories in relation to the efforts to find a unique theoretical foundation for healthcare science and practice. It is suggested that Parse's division in a totality vs. a simultaneity paradigm is an artificial distinction. The discussion is concluded with reflections about Peplau's interpersonal relation model, a patient-oriented perspective and psychodynamic theory, as example of a theory, which may help to further understand patients’ existential situation. [ABSTRACT FROM AUTHOR]

The aim of this study was to explore how people suffering from long-term mental illness and who live in the community experience their daily lives. The study was based on an ethnographic framework involving participant observations with 23 individuals from two rehabilitation centres and interviews with six women and two men. The observational notes and interviews were recorded, transcribed into the data and analysed based on the phases of hermeneutic interpretation. The process consisted of identifying tentative interpretations that highlighted various impediments that prevent people with long-term mental illness from having an active life. The impediments can also be interpreted as a form of alienation, an interpersonal phenomenon and a consequence due to of the lack of social acceptance towards mental illness. The participants expressed concern about the future and lack of hope. Viewing themselves as being ‘odd’ is not a symptom of mental illness, but rather evidence of experiencing existential and social alienation not only as a consequence of other people's reactions but also their own negative attitudes towards mental illness and effects of their cognitive dysfunction. [ABSTRACT FROM AUTHOR]

Summary • Little attention is paid in Emergency Care Units (ECUs) in Sweden to the special needs of older people. • The aim of this study was thus to analyse older people's basic needs in the emergency care environment. • The study was carried out with a life-world interpretative approach, and the theoretical framework for interpretation was Abraham Maslow's theory of motivation and personality. • Seven informants aged between 65 and 88 years, with various experiences of being patients with urgent as well as non-urgent health-related problems, were interviewed about their experiences of ECU care. • Their basic needs at the lower levels of Maslow's hierarchy were well-represented in the data. Higher needs, such as desire to know and understand, appeared to be totally neglected. Safety needs dominated the whole situation. • Our conclusion is that standards of care must be developed in Sweden to make older patients feel safer and more secure in ECUs. Furthermore, the principles of nursing care for older patients need to be defined in order to encourage them to take an active part in their own health process. [ABSTRACT FROM AUTHOR]

Psychiatric care and home care service – an exploration of the professional world encountered by persons with long-term mental illness This study focuses on the views of professional health care providers within a geographical district in Sweden. A total of 52 interviews with persons representing different professional levels within psychiatry and the social services were conducted. The purpose was to compare their understanding of what their responsibility entailed as well as their perceptions of goals and required competence. A content analysis, supplemented with interpretations within a hermeneutic tradition, showed that there are both similarities and differences within and between the two organizations. A common finding is that professionals with the least education are to a great extent responsible for the practical care of persons with long-term mental illness. The implication of this finding is that it is important to be aware of this division of responsibility when developing psychiatric nursing and the home care services according to the needs of long-term mentally ill patients. [ABSTRACT FROM AUTHOR]

Pre-understanding and openness – a relationship without hope? In all research, quantitative as well as qualitative, we have to deal with our presuppositions in order to remain open throughout the whole process of inquiry. If we fail to do so the findings might be little more than a reflected image of something already existing in our understanding. The question dealt with in this paper is: how can we gain increased openness by being more aware of our presuppositions. The aim was to investigate the intentional structure of pre-understanding and its effects upon data-collection as well as data-analysis and conclusions in research. The question of pre-understanding is central in Gadamer’s philosophy, even if he is not the first one to discuss this concept. Gadamer further developed the philosophy of understanding. According to him pre- understanding is an intentional structure of feelings and thoughts, which is activated when we regard something as something. By studying the structure of pre-understanding we became more aware of its effect upon understanding. In this paper, theoretical frameworks within cognitive and social psychology as well as psychoanalytic object-relation-theory were compared with Gadamer’s philosophy concerning the conditions of human understanding. Finally the possibility of increased openness in the process of research was discussed. (Such openness is related to knowledge about the structure of pre-understanding.). [ABSTRACT FROM AUTHOR]