Terese Bondas

The aim is to understand the experience of being cared for in psychiatric care as a patient and as a parent. Parenthood represents the natural form of human caring, a human directedness regardless of gender. The study has its starting point in this image, as it applies to mothers who receive care as provided in a psychiatric care context. The theoretical perspective is the theory of caritative caring, and the methodological approach is the philosophical hermeneutics outlined by Gadamer. The sample was purposeful: 10 mothers who experienced being a mother while suffering from mental illness and receiving care from professionals in psychiatric specialist health care contexts. The interpretation process is inductive, deductive, and abductive, and includes different levels of rational, contextual, existential, and ontological interpretation supported by the chosen theoretical perspective and the philosophy of ethics outlined by Emmanuel Levinas. The interpretation on the contextual leve...

To integrate the current international knowledge and enhance our understanding of the experiences of older people of being cared for in nursing homes. There is a lack of integrated knowledge to help face the challenge of providing care to older people in nursing homes. Understanding the experiences of older people regarding their own care leads to interventions for reducing older people's suffering, while living in nursing homes. Keywords describing the experiences of being cared for in nursing homes were used to systematically search electronic databases for qualitative research articles. A meta-synthesis study employing the interpretative meta-ethnography approach devised by Noblit and Hare was carried out to analyse seven qualitative articles identified during the search process. Seven studies included in this meta-synthesis were published between 2007 and 2015. The experiences of older people of being cared for in nursing homes were expressed by the metaphor 'retaining the meaning of being alive'. Older people wished for a homelike place where they would be delivered care with the consideration of all its humanistic aspects. While conflict between their expectations and organizational demands damaged this sought ideal, adjustment to life conditions and taking an active role led to a feeling of being alive. This meta-synthesis integrates our knowledge on organizational and administrative demands, and personal factors influencing the provision of individualized care in nursing homes. The mental functionality of older people that suffer from dementia might impact on their ability to be involved in research and have a 'voice' in terms of their experience of being cared for in nursing homes. The institutional character of the nursing home restricts older people's decision-making. The challenge in nursing home care is to balance the tensions between the individual needs and the collective dimensions of care. Nurse policymakers need to consider the ambience in nursing homes, develop a caring culture for the provision of a holistic care to older people and make the nursing home as close to a home as possible.

The objective was to explore the experiences of CCNs in relation to relatives of elderly patients 80 years and older admitted to ICU. Through methods grounded in phenomenology, six CCNs were purposefully selected for their experiences with relatives of elderly patients admitted to an ICU in Norway. Each CCN participated in semi-structured personal interviews. Using content analysis, interviews were coded and categories and themes were identified. An overall theme emerged: "CCNs ambivalent interactive struggle with the relatives of elderly patients", which reflected the mixed feelings that CCNs recalled having towards relatives. Two themes emerged during the analysis. These were: "relatives are a resource for CCNs and the patient"; and "relatives are seen as challenge". Six sub-themes were identified: (1) CCNs are relying on relatives, (2) relatives and their understanding of the situation, (3) relatives are committed, (4) relatives have high expectations, (5) relatives can be seen as burden and (6) relatives with cultural differences are a challenge. CCN's experiences with the relatives of elderly patients in ICU represent a significant personal, mixed struggle. The findings indicate that development of communication, education, reflection and a more structured organization of intensive care unit can improve results for CCNs and may improve the possibilities for CCNs to promote an excellent family nursing for the elderly patient and his relatives.

Recently graduated nurses are the future of the nursing profession and the municipal health care that will need nursing competency for an increasing number of frail elderly persons. This study is part of a larger project on newly graduated nurses where previous research indicated that building professional pride at their workplace could be important for remaining in the profession and in municipal health care. However, the recently graduated nurse's first job assignment in municipal health care can also be a critical period with cuts in their pride as nurses who may have an impact on nursing care for their patients. The aim of this study is to illuminate recently graduated nurses' experiences with professional pride in municipal health and care services. A phenomenological hermeneutic approach was chosen to illuminate meaning. A purposive sample of eight recently graduated nurses working in nursing homes or home health care was chosen for this study with narrative interviews and diaries. Three themes were identified: doing the good thing and doing what is right; being recognized and confirmed; and finally thriving in a community of practice. An important source of pride is the relation to patients. Recently graduated nurses build their professional pride in an active and social process in a community of practice. The first cut in their professional pride seems to take place when they were not recognized and confirmed as professional persons. Recently graduated nurses in municipal health care describe their professional pride as a complex phenomenon with relational, dynamic and collective dimensions. The cuts in their pride may hurt their identity and nursing care.

Unnecessary routine interventions in uncomplicated labour and birth, like cardiotocography (CTG), amniotomy, use of scalp electrode and oxytocin treatment, are associated with further interventions that could harm the woman and the infant. A four year Action Research (AR) project was done on a labour ward to enhance the capacity of local midwives in the promotion of physiological labour and birth. To describe the use of interventions during labour and birth in healthy women at term with spontaneous onset of labour, before and after initiation of an Action Research project. A retrospective before and after comparative study of clinical records from 2009 (before) and 2012 (after), based on a random selection of records from primiparous and multiparous women. Outcome measures were duration of admission CTG, frequency of admission CTG over 30min, frequency of amniotomy, use of scalp electrode, and frequency of oxytocin augmentation in spontaneous labour. 903 records were included. The duration of admission CTG (p=0.001), frequency of admission CTG duration over 30min (p=<0.001), the use of scalp electrodes (p=<0.001), and use of oxytocin augmentation of spontaneous labour (p=0.014) were reduced significantly after initiation of the AR project. There were no significant differences in frequency of amniotomy, duration of total CTG, postpartum bleeding, sphincter tears, Apgar score <5 at 5min, and mode of birth. Following an AR project, several interventions were reduced during labour and birth. Controlled studies in other settings are needed to assess the impact of collaborative action on decreasing unnecessary interventions.

ABSTRACT PURPOSE: To illuminate experiences and perceptions of caring in the maternity care culture of immigrant new mothers in Finland.DESIGN: This is a descriptive interpretive ethnography.PARTICIPANTS AND SETTING: Seventeen new mothers from different cultures on a maternity ward in a medium-sized hospital in Finland.METHODS: Focused ethnographic analysis and interpretation of interviews, observations, and field notes were used.FINDINGS: Caring was part of the positive experience of childbearing and beneficial for the health and well-being of the immigrant new mothers. Negative experiences of health care impaired their well-being. The resources of Finnish maternity care and cultural knowledge of the nurses facilitated the caring. The policy and attitude of Finnish society encouraged childbearing. The immigration regulations affected support during childbearing negatively and tended to caused loneliness. The Finnish maternity care was not fully adapted to the mothers' wishes to understand the organization of Finnish maternity care, to communicate, to breastfeed, and to have family-centered care, a flexible length of stay in the hospital, and extended support after childbirth.CONCLUSION: Caring improves the childbearing experience and the well-being and health of new immigrant mothers; therefore, caring needs to be emphasized in maternity care, health care administration, and nursing education.

The aim of this article is to articulate the essence and constituents of neonatal intensive care unit (NICU) nurses' experiences in enacting skin-to-skin care (SSC) for preterm newborns and their parents. SSC is commonly employed in high-tech NICUs, which entails a movement from maternal-infant separation. Parents' opportunities for performing the practice have been addressed to NICU staff, with attitude and environment having crucial influence. The study was carried out with a reflective lifeworld research approach. Data were collected in Denmark, Sweden, and Norway by open-dialogue interviews with a purposive sample of 18 NICU nurses to achieve the essence of and variation within the phenomenon. NICU nurses experience balancing what they consider preterm newborns' current and developmental needs, with readiness in both parents for SSC. They share an experience of a change in the history of NICU care to increased focus on the meaning of proximity and touch for the infan...

This study attempts to contribute to the knowledge of caring science and mental health care by means of a profound understanding of the patients' existential world when being a mother in receipt of psychiatric care, with focus on inner processes such as health and suffering. Mothers struggle to cope with the demands of the illness and the responsibility for their children. They see themselves through their children and regard the child as an important part of themselves. Mothers experience guilt and shame related to motherhood, and when they have to relinquish their responsibility as a mother, they consider themselves a failure. Despite a range of practical and emotional difficulties, motherhood involved extremely positive experiences, which provide a purpose as well as fulfilment and meaning in life. This study is rooted in philosophical hermeneutics inspired by Gadamer with an inductive-deductive-abductive approach. Interpretation of the data was made on different levels of ab...

The phenomenological study of the lived experiences of pregnancy described in this article is part of a Finnish caring science research program. Eighty interviews with 40 women combined with nonparticipant observation were analyzed according to Colaizzi. Pregnant women wishing for a perfect child want to promote the health of their unborn baby, no longer take health for granted, and try to change their health behavior. Their altered mode of being involves body changes, variations in mood, and worries. The striving to achieve family communion is seen in the evolving significance of the baby; in dreams, hopes, and plans; and in changing relationships. In relation to Eriksson's ontological health model, the joy and suffering in pregnancy are based on being there for another. Taking seriously the women's experiences and the hidden questions that reveal suffering in both lay and professional caring might prevent the serious postpartum misery of motherhood.

The aim of this study was to increase understanding of how individual patient care and the ethical principles prescribed for nursing care are implemented in nursing documentation. The method used was a metasynthesis of the results of 14 qualitative research reports. The results indicate that individualized patient care is not visible in nurses' documentation of care. It seems that nurses describe their tasks more frequently than patients' experiences of their care. The results also show that the structure of nursing documentation and the forms or manner of recording presupposed by the organization may prevent individual recording of patient care. In order to obtain visibility for good patient-centred and ethical nursing care, an effort should be made to influence how the content of nursing care is documented and made an essential part of individual patient care. If the content of this documentation does not give an accurate picture of care, patients' right to receive good nursing care may not be realized.

Increase understanding of nursing leadership in group clinical supervision (CS). Leadership in CS has received little interest besides the theories in use and administrative CS. Hermeneutic interpretation of written narratives of 24 clinical nurse supervisors. Continuity in structuring, story and mission and reflection in group and leadership processes and theories of nursing and caring characterize leadership in CS. Leadership by inhibiting and creating fear, inapproachability and indistinctiveness were patterns in content brought to CS. Supervision when leadership was involved illuminated a reflexive change in focus from leadership to nursing care, from particular experiences to nursing and caring science, and from the unfamiliar to the well known and the well known to the unknown. Continuity and reflective changes using nursing and caring theories seem to be core ideas of nursing leadership from the perspective of CS. The poles of separation and communion show opposites of nursing leadership as it is illuminated in CS. The findings add knowledge to Bondas' theory of caritative leadership. CS is a reflexive practice of support and guidance that seems to have an impact on the trajectory of nursing care and staff development using nursing and caring theories.